Current results of chemotherapy in non-small cell lung cancer

From 1983 to 1988, two prospective randomized studies were conducted in the treatment of patients with inoperable non-small cell lung cancer (NSCLC). The first was a comparison of cisplatin (CDDP) alone vs CDDP plus vindesine (VDS) (CV-1), and the second was the comparison of CDDP plus VDS (CV-2) vs CDDP plus VDS plus mitomycin (MMC) (CVM) vs CDDP plus etoposide alternating with VDS plus MMC (CE/VM). A total of 345 patients entered into these two studies were evaluated. The response rates were 9.3% for CDDP alone, 26.8% for CV-1, 33.3% for CV-2, 42.6% for CVM, and 19.1% for CE/VE. There were significant differences in response rates between CDDP alone and CV-1 (p less than 0.01), and CVM and CE/VM (p less than 0.01). No differences were observed in the durations of response and survival among the five treatment arms. Females responded to chemotherapy better than males, and squamous cell carcinoma responded better than adenocarcinoma. Sex, performance status and stage were significant as prognostic factors in advanced NSCLC patients. Responders to chemotherapy live longer than nonresponders. In conclusion, CVM is considered to be currently best available regimen. No survival benefit has been proved for any treatments for advanced NSCLC. Chemotherapy for NSCLC is still investigational.