Premium
Induction chemotherapy employing dose‐intense cisplatin with mitomycin and vinblastine (MVP400), followed by thoracic surgery or irradiation, for patients with stage III nonsmall cell lung carcinoma
Author(s) -
Ng Kenneth K.,
Kris Mark G.,
Ginsberg Robert J.,
Heelan Robert T.,
Pisters Katherine M. W.,
Miller Vincent A.,
Grant Stefan C.,
Bains Manjit,
Rusch Valerie,
Rosenzweig Kenneth E.,
Martini Nael
Publication year - 1999
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19991001)86:7<1189::aid-cncr13>3.0.co;2-n
Subject(s) - medicine , vinblastine , regimen , surgery , chemotherapy , induction chemotherapy , lung cancer , stage (stratigraphy) , mitomycin c , cisplatin , paleontology , biology
BACKGROUND Cisplatin‐based induction chemotherapy before surgery or irradiation has improved the survival of patients with Stage III nonsmall cell lung carcinoma (NSCLC). Encouraged by earlier results with preoperative MVP (cisplatin [120 mg/m 2 or 25 mg/m 2 /week], vinblastine, and mitomycin) for Stage IIIA patients with clinically apparent mediastinal (N2) disease, the authors conducted a Phase II trial of the safety and efficacy of induction MVP400 with the dose intensity of cisplatin doubled from 25 to 50 mg/m 2 per week. METHODS From October 1992 to March 1996, 37 patients with Stage IIIA (26) or Stage IIIB (11) NSCLC began the MVP400 induction chemotherapy program. Four doses of cisplatin (100 mg/m 2 ), 7 doses of vinblastine, and 2 doses of mitomycin were given over 9 weeks. Patients received either surgery or irradiation after induction treatment. RESULTS Overall, the response rate was 65% (95% confidence interval, 49–81%) with a complete resection rate of 67%. The median survival was 17 months, with 66% of patients alive at 1 year. Complete resection and Stage IIIA involvement were favorable prognostic indicators for survival. No Stage IIIB patients underwent a complete resection. Myelosuppression was the most common side effect. There were no treatment‐related deaths. CONCLUSIONS Although high response and complete resection rates were again demonstrated, results with the MVP400 regimen were not improved over those achieved with MVP regimen tested earlier with Stage IIIA (N2) patients. The authors continue to recommend MVP as an induction chemotherapy regimen for clinical trials. Cancer 1999;86:1189–97. © 1999 American Cancer Society.