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British Journal of Cancer logoLink to British Journal of Cancer
. 1991 Feb;63(2):293–297. doi: 10.1038/bjc.1991.68

High dose combination chemotherapy with ifosfamide, cyclophosphamide or cisplatin, mitomycin C and mustine with autologous bone marrow support in advanced non-small cell lung cancer. A phase I/II study.

S A Gomm 1, N Thatcher 1, A Cuthbert 1, J Chang 1, H Burmester 1, P Hall 1, K B Carroll 1
PMCID: PMC1971797  PMID: 1847648

Abstract

Twenty-three patients with advanced NSCLC were treated with high dose chemotherapy using four agents and autologous bone marrow reinfusion. Ten patients received two bolus doses of cyclophosphamide (maximum tolerated total dose 10 G m-2), ifosfamide as a 24 h infusion (11 G m-2) followed by mitomycin C (70 mg m-2) as a subsequent 24 h infusion and mustine as two boluses (total dose 30 mg m-2). Another 13 patients received the same agents except cisplatin was substituted for cyclophosphamide, two doses (total dose 100 mg m-2) being given in a 24 h period. The median time of recovery to greater than or equal to 20,000 platelets was 21 days and of neutropaenia greater than or equal to 500 was 12-15 days. Unusual non-haematological toxicity e.g. cardiomyopathy, colitis, veno occlusive disease was not noted, all patients being given regular selenium and other trace elements. Three patients died in the first 2 weeks. There were five complete responses (22%) and 12 partial responses (52%) with four patients (2CR, 2PR) still alive at 27, 48, 73 and 82 weeks. The patient's Karnofsky performance in the cisplatin regimen improved over pretreatment values when compared a month after the end of treatment. The high dose regimen was associated with a high (74%) response rate, but with an overall median survival of only 6 months. The regimen has no advantage over conventional doses with the same agents in patients with metastatic NSCLC.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bakowski M. T., Crouch J. C. Chemotherapy of non-small cell lung cancer: a reappraisal and a look to the future. Cancer Treat Rev. 1983 Sep;10(3):159–172. doi: 10.1016/0305-7372(83)90030-0. [DOI] [PubMed] [Google Scholar]
  2. Bronchud M. H., Scarffe J. H., Thatcher N., Crowther D., Souza L. M., Alton N. K., Testa N. G., Dexter T. M. Phase I/II study of recombinant human granulocyte colony-stimulating factor in patients receiving intensive chemotherapy for small cell lung cancer. Br J Cancer. 1987 Dec;56(6):809–813. doi: 10.1038/bjc.1987.295. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cheson B. D., Lacerna L., Leyland-Jones B., Sarosy G., Wittes R. E. Autologous bone marrow transplantation. Current status and future directions. Ann Intern Med. 1989 Jan 1;110(1):51–65. doi: 10.7326/0003-4819-110-1-51. [DOI] [PubMed] [Google Scholar]
  4. Frei E., 3rd Antitumor agents--dose response curve clinical and experimental considerations. Exp Hematol. 1979;7 (Suppl 5):262–264. [PubMed] [Google Scholar]
  5. Frei E., 3rd, Antman K., Teicher B., Eder P., Schnipper L. Bone marrow autotransplantation for solid tumors--prospects. J Clin Oncol. 1989 Apr;7(4):515–526. doi: 10.1200/JCO.1989.7.4.515. [DOI] [PubMed] [Google Scholar]
  6. Frei E., 3rd, Canellos G. P. Dose: a critical factor in cancer chemotherapy. Am J Med. 1980 Oct;69(4):585–594. doi: 10.1016/0002-9343(80)90472-6. [DOI] [PubMed] [Google Scholar]
  7. Leff R. S., Thompson J. M., Johnson D. B., Mosley K. R., Daly M. B., Knight W. A., 3rd, Ruxer R. L., Jr, Messerschmidt G. L. Phase II trial of high-dose melphalan and autologous bone marrow transplantation for metastatic colon carcinoma. J Clin Oncol. 1986 Nov;4(11):1586–1591. doi: 10.1200/JCO.1986.4.11.1586. [DOI] [PubMed] [Google Scholar]
  8. Peters W. P., Eder J. P., Henner W. D., Schryber S., Wilmore D., Finberg R., Schoenfeld D., Bast R., Gargone B., Antman K. High-dose combination alkylating agents with autologous bone marrow support: a Phase 1 trial. J Clin Oncol. 1986 May;4(5):646–654. doi: 10.1200/JCO.1986.4.5.646. [DOI] [PubMed] [Google Scholar]
  9. Schabel F. M., Jr, Trader M. W., Laster W. R., Jr, Wheeler G. P., Witt M. H. Patterns of resistance and therapeutic synergism among alkylating agents. Antibiot Chemother (1971) 1978;23:200–215. doi: 10.1159/000401484. [DOI] [PubMed] [Google Scholar]
  10. Selawry O. S. Monochemotherapy of bronchogenic carcinoma withs special reference to cell type. Cancer Chemother Rep 3. 1973 Mar;4(2):177–188. [PubMed] [Google Scholar]
  11. Slease R. B., Benear J. B., Selby G. B., Reitz C. L., Hughes W. L., Watkins C. L., Epstein R. B. High-dose combination alkylating agent therapy with autologous bone marrow rescue for refractory solid tumors. J Clin Oncol. 1988 Aug;6(8):1314–1320. doi: 10.1200/JCO.1988.6.8.1314. [DOI] [PubMed] [Google Scholar]
  12. Teicher B. A., Cucchi C. A., Lee J. B., Flatow J. L., Rosowsky A., Frei E., 3rd Alkylating agents: in vitro studies of cross-resistance patterns in human cell lines. Cancer Res. 1986 Sep;46(9):4379–4383. [PubMed] [Google Scholar]
  13. Thatcher D., Lind M., Morgenstern G., Carr T., Chadwick G., Jones R., Craig P. High-dose, double alkylating agent chemotherapy with DTIC, melphalan, or ifosfamide and marrow rescue for metastatic malignant melanoma. Cancer. 1989 Apr 1;63(7):1296–1302. doi: 10.1002/1097-0142(19890401)63:7<1296::aid-cncr2820630712>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  14. Williams S. F., Bitran J. D., Hoffman P. C., Robin E., Fullem L., Beschorner J., Golick J., Golomb H. M. High-dose, multiple-alkylator chemotherapy with autologous bone marrow reinfusion in patients with advanced non-small cell lung cancer. Cancer. 1989 Jan 15;63(2):238–242. doi: 10.1002/1097-0142(19890115)63:2<238::aid-cncr2820630206>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]

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