W. K. EVANS, M.D.; R. FELD, M.D.; N. MURRAY, M.D.; A. WILLAN, Ph.D., M.D.; D. OSOBA, M.D.; F. A. SHEPHERD, M.D.; D. A. CLARK, M.D., Ph.D.; M. LEVITT, M.Sc., M.D.; A. MacDONALD, M.D.; K. WILSON, M.B.; W. SHELLEY, M.D.; J. PATER, M.Sc
The National Cancer Institute of Canada Clinical Trials Group conducted a prospective randomized study comparing standard chemotherapy with alternating chemotherapy in patients with extensive small cell lung cancer. "Standard" treatment consisted of cyclophosphamide (1000 mg/m2 body surface area); doxorubicin (50 mg/m2), and vincristine (2 mg) every 3 weeks for six courses. Alternating chemotherapy was cyclophosphamide, doxorubicin, and vincristine alternating with etoposide (100 mg/m2 on days 1 to 3) and cisplatin (25 mg/m2 on days 1 to 3) every 3 weeks for six treatment cycles. Two hundred eighty-nine patients were eligible and evaluable for response to therapy and survival. Best response was higher in patients on alternating chemotherapy (complete plus partial response, 80% compared with 63.2%p < 0.002). Progression-free survival for patients on alternating chemotherapy was superior (p < 0.0001) as was overall survival (p = 0.03). Major toxicities were equally frequent in both treatment groups. These results show a modest superiority of alternating chemotherapy over standard therapy in extensive small cell lung cancer.
EVANS WK, FELD R, MURRAY N, et al. Superiority of Alternating Non-Cross-Resistant Chemotherapy in Extensive Small Cell Lung Cancer: A Multicenter, Randomized Clinical Trial by the National Cancer Institute of Canada. Ann Intern Med. 1987;107:451–458. doi: https://doi.org/10.7326/0003-4819-107-4-451
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Published: Ann Intern Med. 1987;107(4):451-458.
Hematology/Oncology, Lung Cancer, Pulmonary/Critical Care.
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