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High-dose cisplatin and mitomycin C in advanced non-small cell lung cancer: a phase II study of the Northern California Oncology Group

  • Original Articles
  • High-Dose Cisplatin, Mitomycin C, Advanced Non-small Cell Lung Cancer
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Summary

To investigate chemotherapeutic dose intensity in advanced non-small-cell lung cancer (NSCLC), we evaluated a pharmacokinetically designed schedule of high-dose cisplatin (200 mg/m2 per 28-day cycle) plus mitomycin C. Between March 1987 and March 1989, 62 patients were registered for a phase II study of the Northern California Oncology Group (NCOG). The treatment schedule consisted of cisplatin in hypertonic saline given on a divided days 1 and 8 schedule (100 mg/m2 on each day) plus mitomycin C given at a dose of 8 mg/m2 on day 1 of each cycle. In 61 patients evaluable for response analysis, the overall response rate was 39% (24/61), with a complete response being achieved in 6% (4/61) of cases and a partial response, in 33% (20/61). The response according to reviewed histologic subtype included squamous, 53% of patients (10/19); large cell, 31% (4/13); and adenocarcinoma, 34% (10/29). The median survival for all patients was 19.3 weeks. The mean cisplatin and mitomycin C delivered dose intensities in this study were 45 mg/m2 per week (90% of the projected dose) and 1.5 mg/m2 per week (75%). The toxicity of this combination regimen in the 62 enrolled patients was significant but manageable. Leukopenia (WBC, <1,000/mm3) and thrombocytopenia (platelets, <25,000/mm3) occurred in 3# and 8% of patients treated, respectively. Dose-limiting renal toxicity and clinically significant ototoxicity developed in 8 patients each (13%), and a peripheral sensory neuropathy was observed in 17 cases (27%). Whether this type of dose-intensive therapy results in an improved therapeutic index in NSCLC is currently being evaluated in a randomized comparative trial versus standard-dose cisplatin therapy.

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Authors and Affiliations

  1. Northern California Oncology Group, Northern California Cancer Center, Belmont, California

    David R. Gandara, Edith A. Perez, Howard Wold, Vincent Caggiano, Mary Malec, David K. Ahn, Fredrick Meyers & Robert W. Carlson

  2. Hematology/Oncology Service, Letterman Army Medical Center, San Francisco, California

    Howard Wold

  3. Sacramento Community Clinical Oncology Program, Sacramento, California

    Vincent Caggiano

  4. Department of Medicine, Stanford University, Stanford, California

    Robert W. Carlson

  5. Division of Hematology, Oncologv University of California, Davis

    David R. Gandara, Edith A. Perez & Fredrick Meyers

Authors
  1. David R. Gandara
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  2. Edith A. Perez
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  3. Howard Wold
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  4. Vincent Caggiano
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  5. Mary Malec
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  6. David K. Ahn
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  7. Fredrick Meyers
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  8. Robert W. Carlson
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Additional information

This research was supported in part by grants CA 21 744, CA 25 838, CA 25 827, CA 45 466, CA 37 457, CA 39 098, CA 35 016, CA 35 283, Bristol-Myers Company, and the Veterans Administration. One of the authors (R.W.C.) is the recipient of an American Cancer Society Clinical Oncology Cancer Development Award

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Gandara, D.R., Perez, E.A., Wold, H. et al. High-dose cisplatin and mitomycin C in advanced non-small cell lung cancer: a phase II study of the Northern California Oncology Group. Cancer Chemother. Pharmacol. 27, 243–247 (1990). https://doi.org/10.1007/BF00685721

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