Abstracts/Lung Cancer 13 (1995) 81-104

lherapy in patienls wth small cell lang cancer. Methods S~xty-one previously untreated small cell lung cancer patents wth measurable lesion (s) received cisplalm (30 mum’ IV. day I - 3) and etoposlde( IO0 mp/m’ IV. day I - 3). In patnerds with limited disease, afler completion of 6 cycles of PVT’ chemotherapy, chest and prophylatic brain madiation was performed in case of complete responder, chesl irradmtnon only in partial responder. Resulrs. (I) Of 55 evaluable patients. I3 (24%) bad a compleb response and 29 (53%) had a pamal resp0n.w (2) The median suwival time was 55 8 weeks for all pattiems (N = 55). 6 I. I weeks for limited disease (N = 3 I). 5 I 3 weeks for extensive disease R‘I = 24). (3) The reswnse duration was 29. I weeks for responders ( N = 42). (4) There were m significant prognostic factors influencing response rates. (5) The toxicity was tolerable and there was no treatment-related deaths. Conclusron: The PVP mmbmation chemo- therapy as a first-bne therapy was effecrwe and a well-,olera,ed m patients wth small cell lung cancer.

Sequential functional imaging with technetium-99m hex&s-Z- methoryisobutylisonitrile and iridium-Ill octreotide: Cm we predict the response to chemotherapy in small cell lung cancer? Moren~ JL. Caglar M. Bcwia C. Cnllat-Wgoemn N. Morere JP Hopml Rv,cenne CHllBobrgny. Univewle Pa,,s.Y,,,, 125 Route de.%l,ngrczd F-93009 Bobtgny Eur J Nucl Med 1995:22 177-80

A case of small cell Lund carcinoma (SCLC) demonslralmg uptie on functmnal iridium-I Ii octreotide scinttgraphy is presented, Technetum-99m hexak,s-2-melhoxv,sobutvl,san~tr,le <MIBI) scm,,graphy clearly dclineatcd an ah&cc of ~dmnuclidc u&ke at the ,umour site. Thas suggested the presence of multldrug resislance- mediated P glywpmtcin (Pgp) on tumcarcclls, whuh recngruzes cermm chemotherapeutic agents as well as MIBI as a substrate and avoids radlonuchde conccntrataon. Follou~ng three courses of chcmothcrapy, lhep.went failedloImpro\eandeventually*cd Thtscascdemonsva~es the nnponance of func,mnal rmages. ahlch have Ihepotencd ,o prattct the outcome in response ,o chemotherapy

Obesity and therapy-related toxicity in patients treated for small-cell lung cancer Ceorgladls MST Steinberg SM. Hankins LA, lhde DC. Johnson BE. .\ononol lnsr,rures of Heollh, E/de 8. Belhesdo. MD 208X9 J NatI Cancer Ins, 1995:87;3616

Backgmund obese individuals have altered pharmacokme,cs for many md&mons when compared ulul tie mxwbese For the oncologist treamg an obese cancer panen!. these changes m drug dlsposllion may paenually cause mcrcaxd therapy-related toxicity As a consequence. oncolog,s~s frequently treat obese patients wnh dose reductmns m an eflort to decrease chemotherapy toxwty However. little clinical data cwt ,o cilher s~ooort or relate lhis polw Purpose. The clm~cal course of a cohon of ~;,enrs ,rea,ed for ;mali<ell lung cancer (SCLC) was e\alua,cd to determme II Ihe obese patients had an increase in therapy- relalcd loxtc~ty hlerhods. The study sample mcluded 262 pabents wllh hlstologlcally coniirmed SCLC treated in clmical trials from I977 through 1993. Before 1986, pa,,ents with hm,tcd rlage SCLC were treated wdh a cyclophospbamtde-based regonen with (n = 47) orwnhout (n = 46) chest radtotherapy. Subsequent pa,,ents with limited stage dwasc (n = 54) recewed etoposide and wplalin plus ,wicedaily chest rad~olherapy Patients with exleosive stage SCLC were randomly treated with scandarddosc (n = 46) or hnghdose ctoposade plus cisplalm (n = 44). poorask patients wrth extensive stage discase (o = 25) were assrgnd lo nandard dose noposlde plus c~splatm For all patients, aclual body weigh, was used when determming lmtnl doses of chemotherapy The measure of relative wenghl was the body mass index (BMI), which was calcula,cxi from the pre-treatmcn, haght and wgh, &,a The BMI was evaluated both on a contmoum and wlh pa,,enls grouped m,o BMI levels (normal. o&c. and severely c&x) Tooxtc~ty paramc,ers were collected durmg mducrnon chcmolhcrapy and were compared with the BMI In add,,,on. thcovcrall sunival of,heen,lrccohorl wasevaluated. wth pallcots divtdcd into ddTcrent groups based on theur BMI level Resulrs We performed 170 comparisons between the BMI as a ~ontmuum or the BMI level and Ihc I5 ,owdy parameters There were nocons~aenta~~aoanrafs~gni~~acancc foundbetween incre+sing BMI

or BMI levels and increang toxicity from lherapy When survival was evaluated. no statistically sianificard differences were found between . - the survival of padents wthin the ditferent BMI levels. Conclusmns: In this groopof262 patients with SCLC, obesiry at the stanoftreatment was not associated with increased toxicity from trealment or a shortened

survival. No suppa-~ for empiric chemolherapy dose reductions basal on ideal body waghI was evident fmm this audy.

Cirplatinktoposide combined with interferon-gamma in non- small cell lung cancer Pirkcr R. Prior C. wes R. Kneussl M. Oroszy S. Krajnik G et al. Clinic/or Inl@mml Medicme 1. Wohrwgegvrrel 18-20. lo90 Menno Radio1 Onml l994:28:395- 7.

In order to assess the clinical eficaq of interferon-gamma (IFN- gamma) in non-small cell long cancer OJSCLC), IFN-gamma was added to three cycles of chemotherapy (cisplatio. etoposide) and applied as maintenance therapy in patients with advanced NSCLC. &far. 32 patients have been admitted to thw trial. Twenty-nine oatients were evaluahle with regard to response. Complcte~remis~ions. partial remissions and minor responses were observed m O%, 7% and 28% of the pabents. respectively. Stable disease was see,, m I (3%) paben, and progressive disease in I8 (62%) patients In the casz of progresswe disease. the tream~ent wasdismolinoed. The duration of medmn survival was 7 months and the I-year survival rate was 40%. Only few patients did wewe LFN-gamma maintenance therapy. Funher follow-up of the patients is required morderto determinetheinfluenceorthis combined !rea!me”! 0” long-teml suN1val.

Hoosier Oncology Group studies in extensive and recurrent small cell lung cancer Emhom LH. Lochrer PJ. Unwersrrv Ilo,vpprrol. 550 X Innwwv HIvd Indmnopohs, ,A’ J620.1.5265 Semi,, Oncal 1995.22 Suppl 2 28-3 I.

S~gndicant advances have been made ,n the Ircaunen, of small cell lunncanceriSCLC)dwin~,epastIwod~~cs Ma~randwlw~lablc m~&ement has been &hi&cd in pahenls wih llmllcd dlseasc However. progress III errlensivc SCLC has been more clusw Dcspttc thousands of pa,,c”,s entered m,o numerous phase II and phase ill studies. d IS s,dl debamble whelher any pan~cular rcguncn 1s ropenor molder combination chemolhcrapy rcgmwis first sludxd 2O~cars ago From May 1989 through January 1991. 171 paucn,s u,lh c\,enrnc SCLC were entered inlo a Hoosier Oncology Croup phase Ill s(ud! companngeloposlde/clsplalin(W) wlh ctoposidc/lfoslanlldc/clsplaun (VIP) There were 166 patxnts fully walublc for rcsponsc and suw~\.aI As expected. hematologic toxnty was more sevcrc 11, Ihe pa,nUs m the VIP arm, bu, both arms had a 6% 10 7% treatnem-rclalcd monabl! rate The response rates were similar (70% v 66%. wtlh 18% and 2 I% complele remissions). However, there was improvcxi survval m ,hc VIP arm (P = .03). Th,s was rnos, pronounced at Ihe lad of Ihc sun.~\al curves. with 2- and 3. year s~rvwal ralcs of 12% and 5% for VIP .xmpared wdhS%andU?&for VP Adiffcrcnc formof VIPchcmothrrap! for paems with refractory SCLC wlh no prior llosfamldc also uas evaloated. From February 1990 10 August 1993. 16 pa,,cn,s \\lth previously treated SCLC were trcaicd wllh dad) oral etoposadci ifosfam~delasplattn Thlrty-onc of 4 I cvaluablc pa,~cnls had prior asplatin plus intravcnou cloposidc Myclosupprcsston was s~gnlficanl. with stx treatmen,-related deaths Twenty-lwo of4 I paUcn,s (54%) had an ob~eclwe response. mcludmg SIX (15%) complelc rcnoss~ons The mr,d~an length ofsurv~val was 29 weeks (range. I 10 76 weeks) Dcspllc the toxicily these rcsul,s arc compelitwc wllh man? firs,-line chemotherapy programs This IS a reasonable. aggresswe rcg,mcn for sclccled paucn,s wlh refractory SCLC

The place of ifosfamide in chemotherapy of small cell lung cancer: The Eastern Cooperative Oncology Group experience

and II selected literature update Enmeer DS. Johns Hodms Oncolow Cenler: 600 N iWle Y Ballr~norr, ,ULI il2.97. Semin O&l 1995:22&ppl 2 23-7 .

In a randomtzed Eastern CcqxrabveOncology Group study. smgle- agent ifosfamlde used 10 treat exteosivedtsease small cell lung cancer patients produced a 49% response rare compared with 56% for patients waving standard combmation chemotherapy (cyclophosphamldel doxombicir&mcristiine) When thedrug was combined ~8th carboplatin and etoposlde 10 Lreat extensive- daase small cell lung cancer patients, overall response rate was 83%. median suvival lime was 9 months. and I-year survival rate was 14% The major toxicity wets myelo- suppression. llwse resells confirm those oforher invest@ors who have shown the e,Rctivencss oftbe ifosfamide/cartaplab~elopoade regimen in treatlog patients with small cell lung cancer.