The CancerWeb Report, What's New In Cancer: February, 1997
Lung Cancer

• Gemcitabine/cisplatin combination for advanced non-small-cell lung cancer - Researchers in South Africa described a treatment protocol based on weekly gemcitabine and monthly cisplatin, with the latter starting 2 weeks after gemcitabine. The results, published in the February, 1997 issue of the Journal of Clinical Oncology, indicated an overall response rate of 52% among 50 assessable patients, and a median survival of 13 months with 61% alive at 1 year. Toxicity was relatively mild with lowered white cell and platelet counts in less than half the patients, some nausea and vomiting, and hair loss in a few of those treated. (Abratt, J Clin Oncol 15:744, 1997)

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• Paclitaxel and docetaxel in advanced lung cancer - There is need to try new drugs for lung cancer, and two possibilities, Taxol (paclitaxel) and its relative docetaxel, figured in two early dose-seeking Phase I clinical studies reported in the February, 1997 issue of the Journal of Clinical Oncology. Response rates were similar in both studies. The first from the US National Cancer Institute examined paclitaxel in combination with cisplatin in 50 patients with advanced lung cancer. They first determined the maximum tolerated doses of the two drugs, with and without using growth factor support to stimulate bone marrow recovery. The response rate for the 42 patients with non-small-cell lung cancer was 55% with a 1-year survival rate of 41%. Four of the 8 patients with small cell lung cancer responded (Georgiadis, J Clin Oncol 15:735, 1997). Another early-phase study at the MacCallum Cancer Institute, Melbourne, Australia, used the combination of cisplatin and docetaxel in patients with advanced non-small-cell lung cancer. There was a 44% response rate in evaluable patients (Millward, J Clin Oncol 15:750, 1997). The response rates described in these two reports are high for this type of study, where the primary goals are to find appropriate doses and schedules and to determine the pattern of side-effects produced.

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• Whole-brain radiotherapy plus chemotherapy for lung cancer with brain metastases - In patients with lung cancer who develop brain metastases, the latter can often be removed if there is only one or a small number, otherwise whole-brain radiotherapy is used. The results have been median survivals of 15-18 weeks. Since the blood-brain barrier (the mechanism that keeps substances like drugs out of the brain) may not function well when there is a brain tumor, Researchers at the National Kinki Hospital for Chest Diseases in Japan, treated patients having brain metastases from non-small-cell lung cancer with whole-brain irradiation plus cisplatin, vindesine and mitomycin chemotherapy. As described in the February, 1997 issue of the British Journal of Cancer, responses measured by scans occurred in 76% of the patients, including 25% complete responses, 1-year survival was 40%, and there was improved neurologic function in 55% of the patients. (Furuse, Br J Cancer 75:614, 1997)