Journal of Clinical Oncology, Vol 1, 247-250, Copyright © 1983 by American Society of Clinical Oncology
Combination chemotherapy with cis-diamminedichloroplatinum and vinblastine in advanced non-small cell lung cancer
TM Woodcock, MS Blumenreich, SP Richman, TT Kubota, PS Gentile and JC Allegra
Twenty-seven patients (25 males and 2 females) with histologically
confirmed, unresectable, or metastatic non-small cell lung cancer were
entered on a combination chemotherapy protocol including cisplatinum and
vinblastine sulfate (DDP)(VLB). Patients had to have measurable disease as
defined by the presence of two clearly measurable perpendicular diameters,
be untreated with either chemotherapy or radiation therapy, and give
informed consent to be eligible for study entry. The median age was 57 yr
and the median performance status was 70 (Karnofsky scale); 10 patients had
epidermoid carcinoma, 9 adenocarcinoma, 4 large cell carcinoma, and 4
undifferentiated carcinoma. All patients had intrathoracic disease, 12 also
had extrathoracic lymph node involvement, 8 bone involvement, 2 liver
metastasis, and 2 central nervous system metastasis prior to beginning
chemotherapy; 9 patients had involvement of one site, 12 of two sites, 5 of
three sites, and 1 of four sites. Cisplatinum was given as a short
intravenous infusion of 120 mg/m2 on days 1 and 28, and then every 6 wk.
Vinblastine was administered as an intravenous injection of 8 mg/m2 on days
1, 14, and 28, and then every 3 wk. Patients were evaluated prior to each
course of cisplatinum. If progression occurred, therapy was discontinued.
If stabilization or response was noted, then therapy was continued until
intolerable toxicity or progression supervened. Every patient entered is
considered evaluable for toxicity and response. There were no complete
remissions; 14 patients achieved a partial response, 3 had a minimal
response, 5 had stabilization of their disease, 1 had disease progression,
and 4 are considered to have had drug deaths. Responses were seen after the
first cisplatinum course in 13 patients and after the second in 1.
Toxicities seen were universal nausea and vomiting; elevation of creatinine
occurred in 6 patients, ranging from 2.1 to 14.6 mg/dl, and was clinically
significant in 2 patients. Myelosuppression, with a leukocyte nadir of less
than 3.0 X 10(9)l in 10 cases and platelet nadir of less than 100.0 X
10(9)l was seen in 5 cases and partial hearing deficit occurred in 2
patients. Median survival was 22 wk for the whole group (24 wk for the
whole group if the 4 early drug deaths are excluded). Median survival was
26 wk for responding patients and 13 wk for nonresponding patients (remains
the same if the early deaths are excluded from the latter group).(ABSTRACT
TRUNCATED AT 400 WORDS)
