Journal of Clinical Oncology, Vol 1, 295-301, Copyright © 1983 by American Society of Clinical Oncology
Randomized study of cyclophosphamide, doxorubicin, and etoposide (VP16- 213) with or without cisplatinum in non-small cell lung cancer
JZ Fuks, J Aisner, DA Van Echo, H Schipper, M Levitt, S Ostrow and PH Wiernik
Sixty-eight patients with non-small cell lung cancer were treated in a
prospectively randomized study with cyclophosphamide, doxorubicin
(Adriamycin), and etoposide (VP16-213) with cisplatinum (CAE +/- P).
Response rate, time to progression, and survival of CAE-P treated patients
were each superior compared to those of patients who received CAE therapy.
Of 36 patients, 10 (4 complete remissions, 6 partial remissions) responded
to CAE-P and of 29 patients 3 (1 complete remission, 2 partial remissions)
responded to CAE (p = 0.073). The median time to treatment failure was 22.9
wk for the CAE-P regimen and 15.0 wk for CAE (p = 0.032). The median
survival for patients treated on the regimen with and without cisplatinum
was 34.5 and 22.5 wk, respectively (p = 0.04). There were two CAE-P and one
CAE drug-related deaths. Toxic effects were more severe in the CAE-P
regimen. The addition of cisplatinum to the CAE combination produced an
increase in response rate with significant prolongation in both time to
progression and survival, but did add morbidity. These results suggest that
the combined use of cisplatinum with at least one of the chemotherapeutic
agents in the CAE regimen is synergistic.
