Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1991 Mar;46(3):172–174. doi: 10.1136/thx.46.3.172

Does the substitution of cisplatin in a standard four drug regimen improve survival in small cell carcinoma of the lung? A comparison of two chemotherapy regimens.

A P Smith 1, G Anderson 1, G Chappell 1, D R Bowen 1
PMCID: PMC463022  PMID: 1851339

Abstract

Ninety five patients with small cell carcinoma of the lung were randomly assigned to one of two chemotherapy regimens (VACE or CVACE), each consisting of six cycles at three week intervals. The VACE regimen consisted of six cycles of vincristine 1.2 mg/m2, doxorubicin 40 mg/m2, and cyclophosphamide 700 mg/m2 on day 1 plus etoposide 110 mg/m2 daily for three days. The CVACE regimen was identical to the VACE regimen for cycles 3 and 4; cycles 1, 2, 4, and 6 consisted of etoposide 110 mg/m2 for three days plus cisplatin 100 mg/m2 with mannitol diuresis on the second day. Forty eight patients received VACE and 47 CVACE. Side effects resulted in withdrawal of four patients receiving VACE and six receiving CVACE. Three deaths were attributed to VACE and one to CVACE. Median survival did not differ between the two treatments overall, though there was a small increase in median survival in partial responders receiving CVACE. It is concluded that replacing four of the six cycles of VACE (vincristine, doxorubicin, cyclophosphamide, and etoposide) with etoposide and cisplatin conferred no overall advantage.

Full text

PDF
172

Selected References

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

  1. Aisner J., Whitacre M., Abrams J., Propert K. Doxorubicin, cyclophosphamide, etoposide and platinum, doxorubicin, cyclophosphamide and etoposide for small-cell carcinoma of the lung. Semin Oncol. 1986 Sep;13(3 Suppl 3):54–62. [PubMed] [Google Scholar]
  2. Evans W. K., Feld R., Murray N., Pater J., Shelley W., Willan A., Osoba D., Levitt M., Coy P., Hodson I. The use of VP-16 plus cisplatin during induction chemotherapy for small-cell lung cancer. Semin Oncol. 1986 Sep;13(3 Suppl 3):10–16. [PubMed] [Google Scholar]
  3. Evans W. K., Feld R., Murray N., Willan A., Coy P., Osoba D., Shepherd F. A., Clark D. A., Levitt M., MacDonald A. Superiority of alternating non-cross-resistant chemotherapy in extensive small cell lung cancer. A multicenter, randomized clinical trial by the National Cancer Institute of Canada. Ann Intern Med. 1987 Oct;107(4):451–458. doi: 10.7326/0003-4819-107-4-451. [DOI] [PubMed] [Google Scholar]
  4. Evans W. K., Shepherd F. A., Feld R., Osoba D., Dang P., Deboer G. VP-16 and cisplatin as first-line therapy for small-cell lung cancer. J Clin Oncol. 1985 Nov;3(11):1471–1477. doi: 10.1200/JCO.1985.3.11.1471. [DOI] [PubMed] [Google Scholar]
  5. Levenson R. M., Jr, Ihde D. C., Huberman M. S., Cohen M. H., Bunn P. A., Minna J. D. Phase II trial of cisplatin in small cell carcinoma of the lung. Cancer Treat Rep. 1981 Sep-Oct;65(9-10):905–907. [PubMed] [Google Scholar]
  6. Littlewood T. J., Smith A. P., Anderson G., Chappell A. G., James K. W. Cisplatin and etoposide alternating with vincristine, doxorubicin and cyclophosphamide in patients with small cell lung cancer. Eur J Respir Dis. 1985 Oct;67(4):294–300. [PubMed] [Google Scholar]
  7. Madrigal P. A., Manga G. P., Palomero I., Gomez R. G. VP16-213 combined with cis-platinum (CDDP) in the treatment of small cell carcinoma of the lung (SCLC). Cancer Chemother Pharmacol. 1982;7(2-3):203–204. doi: 10.1007/BF00254549. [DOI] [PubMed] [Google Scholar]
  8. Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. I. Introduction and design. Br J Cancer. 1976 Dec;34(6):585–612. doi: 10.1038/bjc.1976.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Sculier J. P., Klastersky J., Becquart D., Vandermoten G., van Houtte P., Rocmans P., Thiriaux J., Longeval E., Ravez P., Libert P. Phase II study of an intensive combination chemotherapy with cisplatin, adriamycin, etoposide and cyclophosphamide (CAVE) in small cell lung cancer. Eur J Cancer Clin Oncol. 1988 Mar;24(3):519–526. doi: 10.1016/s0277-5379(98)90032-3. [DOI] [PubMed] [Google Scholar]
  11. Simon R. Confidence intervals for reporting results of clinical trials. Ann Intern Med. 1986 Sep;105(3):429–435. doi: 10.7326/0003-4819-105-3-429. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES