1091 The MVP regimen could be less active and toxic than previously described: A divergent report on non-small cell lung cancer

Abstract

The MVP regimen has been the ECOG standard because of a slightly higher response rate, in spite of a significant toxicity (Ruckdeschel JC, et al., JCO 1985; 3:72–9). We started this study with the idea of confirming such therapeutic properties, but we have to admit the achievement of rather divergent results. Fifty-five consecutive pt.s (53 males) with non-small cell lung cancer (NSCLC) were entered on study. Pt.s characteristics were: singe IIIa (10 pt.s), IIIb (23), IV (20), post-surgical recurrent disease (2); squamous (28), adeno (15), large cell (11); performance status 0.1 (24), 2 (31): weight loss in 6 months (4%, median). Pt.s received the MVP regimen with the same dosages, schedule, and precautions used by the ECOG group. The total number of cycles delivered was 144. The dose intensity reached for each drug in the combination was 85% of the projected dose. 51 pt.s were assessable for response and toxicity, while all were evaluated for survival. There were no complete response, 8 partial responses (15%, overall response rate calculated on “intent to treat basis”), 33 stable and 9 progressive diseases. There were no treatment related-deaths and grade 4 toxicity. Three episodes of bacterial infections occurred in neutropenic patients. Grade 2–3 toxicity: alopecia (19%), nausea and vomiting (15%), renal (9%), anaemia (8%), leucopenia (3%), and thrombocytopenia (2%). Median survival for the whole group was 34 wks (95% C.L 28–37 wk.s). The MVP regimen has been the ECOG standard because of a slightly higher response rate, in spite of a significant toxicity (Ruckdeschel JC, et al., JCO 1985; 3:72–9). We started this study with the idea of confirming such therapeutic properties, but we have to admit the achievement of rather divergent results. Fifty-five consecutive pt.s (53 males) with non-small cell lung cancer (NSCLC) were entered on study. Pt.s characteristics were: singe IIIa (10 pt.s), IIIb (23), IV (20), post-surgical recurrent disease (2); squamous (28), adeno (15), large cell (11); performance status 0.1 (24), 2 (31): weight loss in 6 months (4%, median). Pt.s received the MVP regimen with the same dosages, schedule, and precautions used by the ECOG group. The total number of cycles delivered was 144. The dose intensity reached for each drug in the combination was 85% of the projected dose. 51 pt.s were assessable for response and toxicity, while all were evaluated for survival. There were no complete response, 8 partial responses (15%, overall response rate calculated on “intent to treat basis”), 33 stable and 9 progressive diseases. There were no treatment related-deaths and grade 4 toxicity. Three episodes of bacterial infections occurred in neutropenic patients. Grade 2–3 toxicity: alopecia (19%), nausea and vomiting (15%), renal (9%), anaemia (8%), leucopenia (3%), and thrombocytopenia (2%). Median survival for the whole group was 34 wks (95% C.L 28–37 wk.s).