Effect of alternating combination chemotherapy on survival of ambulatory patients with metastatic large-cell and adenocarcinoma of the lung. A southwest oncology group study

Thomas P Miller, T. T. Chen, C. A. Coltman, R. M. O'Bryan, R. B. Vance, G. B. Weiss, W. S. Fletcher, R. L. Stephens, Robert B Livingston

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Abstract

Using a randomized prospective trial design, chemotherapy with 5-fluorouracil, vincristine, and mitomycin C (FOMi) was compared with cyclophosphamide, doxorubicin, and cisplatin (CAP) and with FOMi alternating with CAP (FOMi/CAP) in 452 eligible patients with metastatic large-cell undifferentiated and adenocarcinoma of the lung. Objective responses were obtained in 26%, 17%, and 22% of patients treated with FOMi, CAP, and FOMi/CAP, respectively. The median survival was similar for FOMi, CAP, and FOMi/CAP therapies (20, 24, and 23 weeks, respectively), but the overall survival (log rank test), 1-year survival, and remission duration were longer for FOMi/CAP-treated patients. Survival was significantly longer for fully ambulatory FOMi/CAP-treated patients compared with either FOMi (P = .01) or CAP (P = .04). Younger patients treated with full doses of therapy responded more often than older patients receiving reduced drug doses (26% and 11%, respectively; P = .003). A prognostic factor regression analysis of all eligible patients indicates that sex, performance status, stage, and treatment assigned were important independent variables determining survival (P < .05). Toxicity was comparable in each treatment group.

Original languageEnglish (US)
Pages (from-to)502-508
Number of pages7
JournalJournal of Clinical Oncology
Volume4
Issue number4
StatePublished - 1986

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Combination Drug Therapy
Survival
Mitomycin
Vincristine
Therapeutics
Adenocarcinoma of lung
Fluorouracil
Doxorubicin
Cyclophosphamide
Cisplatin
Statistical Factor Analysis
Regression Analysis
Drug Therapy
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Effect of alternating combination chemotherapy on survival of ambulatory patients with metastatic large-cell and adenocarcinoma of the lung. A southwest oncology group study. / Miller, Thomas P; Chen, T. T.; Coltman, C. A.; O'Bryan, R. M.; Vance, R. B.; Weiss, G. B.; Fletcher, W. S.; Stephens, R. L.; Livingston, Robert B.

In: Journal of Clinical Oncology, Vol. 4, No. 4, 1986, p. 502-508.

Research output: Contribution to journalArticle

Miller, Thomas P ; Chen, T. T. ; Coltman, C. A. ; O'Bryan, R. M. ; Vance, R. B. ; Weiss, G. B. ; Fletcher, W. S. ; Stephens, R. L. ; Livingston, Robert B. / Effect of alternating combination chemotherapy on survival of ambulatory patients with metastatic large-cell and adenocarcinoma of the lung. A southwest oncology group study. In: Journal of Clinical Oncology. 1986 ; Vol. 4, No. 4. pp. 502-508.
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abstract = "Using a randomized prospective trial design, chemotherapy with 5-fluorouracil, vincristine, and mitomycin C (FOMi) was compared with cyclophosphamide, doxorubicin, and cisplatin (CAP) and with FOMi alternating with CAP (FOMi/CAP) in 452 eligible patients with metastatic large-cell undifferentiated and adenocarcinoma of the lung. Objective responses were obtained in 26{\%}, 17{\%}, and 22{\%} of patients treated with FOMi, CAP, and FOMi/CAP, respectively. The median survival was similar for FOMi, CAP, and FOMi/CAP therapies (20, 24, and 23 weeks, respectively), but the overall survival (log rank test), 1-year survival, and remission duration were longer for FOMi/CAP-treated patients. Survival was significantly longer for fully ambulatory FOMi/CAP-treated patients compared with either FOMi (P = .01) or CAP (P = .04). Younger patients treated with full doses of therapy responded more often than older patients receiving reduced drug doses (26{\%} and 11{\%}, respectively; P = .003). A prognostic factor regression analysis of all eligible patients indicates that sex, performance status, stage, and treatment assigned were important independent variables determining survival (P < .05). Toxicity was comparable in each treatment group.",
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