Results of chemotherapy are presented in detail for 603 courses of therapy with 30 drugs in 400 consecutive patients with 22 types of solid tumors. An overall response rate of 20% was observed. The length of response and length of survival was surprisingly short, even in patients who were treated on an adjuvant basis following potentially curative surgery for tumors with poor prognosis. Although chemotherapy provides encouragement and temporary improvement for many patients, and long-term objective benefit for a few, substantial improvement in drugs and methods is needed to provide useful, long-term benefit for the majority of patients with solid tumors.
Chemotherapy in 400 patients during a 34-month period utilized 603 courses of therapy with 30 different agents. In 222 patients with measurable lesions, a 30-percent response rate was observed. Approximately ¼ of the responsive patients had complete responses, lasting up to 24 months, with a median complete response duration of 8 months. Of the 374 evaluable drug courses, 74 (20%) produced responses. Serious complications occurred in 45 patients, but only 3 drug-related deaths occurred. Of the 178 non-evaluable drug courses, 33 were administered prophylactically, as an adjuvant in patients with a poor prognosis. 82% of these patients remained alive and free of disease. 92 non-evaluable patients were treated for known but unmeasurable lesions; 34% of these patients remained alive. The other 49 non-evaluable patients received courses of therapy which were too short to permit evaluation. Of the common tumors, colo-rectal carcinoma and carcinoma of the breast were the most responsive to chemotherapy. The drugs which produced the highest percentage of responses in evaluable patients were 5-FU (24%), MTX (22%), ThioTEPA (21%) and DTIC (21 %), which appeared to be uniquely effective against malignant melanoma.
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