Cyclic alternating combination chemotherapy for small cell bronchogenic carcinoma

M. H. Cohen, D. C. Ihde, P. A. Bunn, B. E. Fossieck, M. J. Matthews, S. E. Shackney, A. Johnston-Early, R. Makuch, J. D. Minna

Research output: Contribution to journalArticle

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Abstract

Sixty-one protocol-eligible patients with small cell bronchogenic carcinoma received cyclic alternating combination chemotherapy with two or three non-cross-resistant drug combinations. No chest or prophylactic brain radiation therapy was used. Twenty-eight months after starting treatment, disease-free survival was 23% for patients achieving a complete response (CR) and 13% overall. Initial treatment consisted of high-dose cyclophosphamide, methotrexate, and CCNU (CMC) for 6 weeks. Patients then received vincristine, adriamycin, and procarbazine (VAP) for 6 weeks. The addition of VAP increased the CR rate from 42% to 74% in limited-disease patients and from 24% to 36% in extensive-disease patients. Half of the patients were randomized to a third combination of VP-16-213 and ifosfamide. These patients were cycled at 6-week intervals through the three drug regimens while the remaining patients were cycled between CMC and VAP. The addition of VP-16-213 and ifosfamide did not increase the CR rate or prolong survival. Only complete responders survived beyond 24 months. Sequential use of non-cross-resistant drug combinations represents one method for increasing the CR rate.

Original languageEnglish (US)
Pages (from-to)163-170
Number of pages8
JournalCancer Treatment Reports
Volume63
Issue number2
StatePublished - 1979

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Small Cell Carcinoma
Bronchogenic Carcinoma
Combination Drug Therapy
Procarbazine
Vincristine
Lomustine
Doxorubicin
Ifosfamide
Etoposide
Drug Combinations
Methotrexate
Cyclophosphamide
Disease-Free Survival
Radiotherapy
Thorax
Survival
Brain
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Cohen, M. H., Ihde, D. C., Bunn, P. A., Fossieck, B. E., Matthews, M. J., Shackney, S. E., ... Minna, J. D. (1979). Cyclic alternating combination chemotherapy for small cell bronchogenic carcinoma. Cancer Treatment Reports, 63(2), 163-170.

Cyclic alternating combination chemotherapy for small cell bronchogenic carcinoma. / Cohen, M. H.; Ihde, D. C.; Bunn, P. A.; Fossieck, B. E.; Matthews, M. J.; Shackney, S. E.; Johnston-Early, A.; Makuch, R.; Minna, J. D.

In: Cancer Treatment Reports, Vol. 63, No. 2, 1979, p. 163-170.

Research output: Contribution to journalArticle

Cohen, MH, Ihde, DC, Bunn, PA, Fossieck, BE, Matthews, MJ, Shackney, SE, Johnston-Early, A, Makuch, R & Minna, JD 1979, 'Cyclic alternating combination chemotherapy for small cell bronchogenic carcinoma', Cancer Treatment Reports, vol. 63, no. 2, pp. 163-170.
Cohen MH, Ihde DC, Bunn PA, Fossieck BE, Matthews MJ, Shackney SE et al. Cyclic alternating combination chemotherapy for small cell bronchogenic carcinoma. Cancer Treatment Reports. 1979;63(2):163-170.
Cohen, M. H. ; Ihde, D. C. ; Bunn, P. A. ; Fossieck, B. E. ; Matthews, M. J. ; Shackney, S. E. ; Johnston-Early, A. ; Makuch, R. ; Minna, J. D. / Cyclic alternating combination chemotherapy for small cell bronchogenic carcinoma. In: Cancer Treatment Reports. 1979 ; Vol. 63, No. 2. pp. 163-170.
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T1 - Cyclic alternating combination chemotherapy for small cell bronchogenic carcinoma

AU - Cohen, M. H.

AU - Ihde, D. C.

AU - Bunn, P. A.

AU - Fossieck, B. E.

AU - Matthews, M. J.

AU - Shackney, S. E.

AU - Johnston-Early, A.

AU - Makuch, R.

AU - Minna, J. D.

PY - 1979

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N2 - Sixty-one protocol-eligible patients with small cell bronchogenic carcinoma received cyclic alternating combination chemotherapy with two or three non-cross-resistant drug combinations. No chest or prophylactic brain radiation therapy was used. Twenty-eight months after starting treatment, disease-free survival was 23% for patients achieving a complete response (CR) and 13% overall. Initial treatment consisted of high-dose cyclophosphamide, methotrexate, and CCNU (CMC) for 6 weeks. Patients then received vincristine, adriamycin, and procarbazine (VAP) for 6 weeks. The addition of VAP increased the CR rate from 42% to 74% in limited-disease patients and from 24% to 36% in extensive-disease patients. Half of the patients were randomized to a third combination of VP-16-213 and ifosfamide. These patients were cycled at 6-week intervals through the three drug regimens while the remaining patients were cycled between CMC and VAP. The addition of VP-16-213 and ifosfamide did not increase the CR rate or prolong survival. Only complete responders survived beyond 24 months. Sequential use of non-cross-resistant drug combinations represents one method for increasing the CR rate.

AB - Sixty-one protocol-eligible patients with small cell bronchogenic carcinoma received cyclic alternating combination chemotherapy with two or three non-cross-resistant drug combinations. No chest or prophylactic brain radiation therapy was used. Twenty-eight months after starting treatment, disease-free survival was 23% for patients achieving a complete response (CR) and 13% overall. Initial treatment consisted of high-dose cyclophosphamide, methotrexate, and CCNU (CMC) for 6 weeks. Patients then received vincristine, adriamycin, and procarbazine (VAP) for 6 weeks. The addition of VAP increased the CR rate from 42% to 74% in limited-disease patients and from 24% to 36% in extensive-disease patients. Half of the patients were randomized to a third combination of VP-16-213 and ifosfamide. These patients were cycled at 6-week intervals through the three drug regimens while the remaining patients were cycled between CMC and VAP. The addition of VP-16-213 and ifosfamide did not increase the CR rate or prolong survival. Only complete responders survived beyond 24 months. Sequential use of non-cross-resistant drug combinations represents one method for increasing the CR rate.

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