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Annals of Oncology 3:813-817, 1992
© 1992 European Society for Medical Oncology

research-article

Extensive small-cell lung cancer. A randomized comparison of two chemotheraphy programs with early crossover in instances of failure

I. Monnet1,, P. Chariot1, E. Quoix2, P. Ruffié3, S. Voisin4, T. Le Chevalier3, J. C. Saltiel4, H. de Cremoux1 and Association pour le Traitement des Tumeurs Intra-Thoraciques (ATTIT)

Departments of Pneumology
1Centre Hospitalier Intercommunal de Créteil Villejuif, France
2Centre Hospitalier Régional et Universitaire de Strasbourg Villejuif, France
3Centre Hospitalier de Corbeil Villejuif, France
4Department of Medicine, Institut Gustave-Roussy Villejuif, France

Isabelle Monnet, MD Clinique de Pathologie Respiratoire Centre Hospitalier Intercommunal 94 000 Créteil, France

Two chemotherapy regimens for patients with extensive small-cell lung cancer were prospectively compared in a randomized multicentric trial with crossover. Every four weeks, 60 consecutive previously untreated patients received either DPE (doxorubicin, cisplatin and etoposide), or CIV (carboplatin, ifosfamide and vincristine) with crossover as soon as progression or end of response were observed. Pretreatment characteristics were similar in the two groups. Fifty-seven patients were evaluated for response. The response rate was higher with the DPE regimen both in first-line (for DPE: response rate 62% (18/29), including 17% (5/29) of complete response (CR), and for CIV: response rate 29% (8/28) with no CR, p<0.02) and in second-line after crossover (for DPE: response rate 45% (9/20) including 5% (1/20) of CR, and for CIV response rate 0%, p<0.02). Major toxicities were equally frequent in both groups. No significant difference was found between median survival times (9.7 months for the DPE group and 10.4 months for the CIV group). We conclude that: 1) DPE is a more active regimen than CIV, both in first-and second-line; 2) no alternating scheme may be considered with these two combinations. Of particular note is the similar median survival times in the two groups, contrasting with the different activities of the two regimens.

chemotherapy, crossover, lung cancer, small cell


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