Combined chemotherapy and differentiation therapy in the treatment of advanced non-small-cell lung cancer.
BACKGROUND
In this phase-II pilot study a cisplatin-based treatment was combined with biological agents capable of inducing differentiation in non-small-cell lung cancer (NSCLC) cells with the aim of ameliorating response to chemotherapy.


METHODS
Forty patients (PTS) with inoperable stage III-B or IV NSCLC were treated with cisplatin (CDDP) 24 mg/m2 on days 1 to 5, 5-fluorouracil (5-FU) 500 mg/m2, by continuous infusion on days 1 to 5 and vindesine (VDS) 3 mg/m2 on days 1 and 5. Beta-interferon (beta-IFN) 1 x 10(6) IU/m2 subcutaneously 3 times a week and retinyl palmitate (R) 50,000 IU orally BID were administered between chemotherapy cycles. Responders were maintained with the same dose of beta-IFN plus R 15,000 IU BID. Half of the PTS had an ECOG performance status of 0-1, 62% of tumours were of squamous histology and 77.5% of PTS had stage IV disease. A median of four courses of chemotherapy per PT was delivered.


RESULTS
Forty PTS were evaluable. Seventeen PTS responded, (RR 42%, 95% C.I. 27%-57%). Of the 17 responders 13 had squamous histology. The median response duration was 5.1 months. The median overall survival was 9.1 months. Gastrointestinal toxicity occurred in 58% of PTS, anaemia in 20%, leukopenia in 30%.


CONCLUSIONS
The association of CDDP, VDS, 5-FU, beta-IFN and R shows activity in NSCLC, particularly in tumours with squamous histology, with a substantial toxicity.
Recchia
F
F
Division of Medicine, Civilian Hospital (Oncology Unit), Avezzano, Italy.
Sica
G
G
De Filippis
S
S
Rea
S
S
Frati
L
L
D000368:Aged; D016588:Anticarcinogenic Agents / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004224:Diterpenes; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D016899:Interferon-beta / Q000008:administration & dosage / Q000009:adverse effects; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D000084562:Retinyl Esters; D015996:Survival Rate; D014751:Vindesine / Q000008:administration & dosage / Q000009:adverse effects; D014801:Vitamin A / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives
D016588:Anticarcinogenic Agents; D004224:Diterpenes; D000084562:Retinyl Esters; D014801:Vitamin A; C014794:retinol palmitate; D016899:Interferon-beta; D002945:Cisplatin; D014751:Vindesine; D005472:Fluorouracil