Abstract
Forty small cell lung cancer (SCLC) patients took part in a phase II study of cyclophosphamide, adriamycin and vincristine combination chemotherapy (CAV) alternating with cisplatin and etoposide (PE). There were 35 men and 5 women with a mean age of 60 years. Most of them had poor prognostic factors: extensive disease (ED) in 26 (65%), poor performance status in 41% and weight loss in 50%. Chemotherapy consisted of three cycles of CAV (cycles 1, 3, and 5) alternating with three cycles of PE (cycles 2, 4, and 6). Objective responses were obtained in 33/40 patients (overall response rate 83%). Among these 17 (43%) achieved complete response (CR) and 16 (40%) partial response (PR). The respective CR and PR rates were 43% and 50% for limited disease (LD) and 42% and 35% for ED. Haematological toxicity was mild-to-moderate and manageable. In particular, a neutropenia occurred in 85% of the patients inducing fever in 23%. Overall median survival was 48 weeks (88 weeks for the LD group and 45 weeks for the ED group; P < 0.01). One-year and 18-month survival rates were respectively 36% and 20%. Our study weakens the hypothesis that alternating combination chemotherapy circumvents the onset of drug resistance in SCLC.
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