Combination chemotherapy with mitomycin, vindesine, and cisplatin for non-small cell lung cancer association of antitumor activity with initial tumor burden and treatment center

Abstract

From 1984 through 1986, 205 patients with non-small cell lung cancer were entered into a group-wide trial of the Swiss Group for Clinical Cancer Research (SAKK). This trial evaluated the combination of mitomycin (8 mg/m2 intravenously [IV] on day 1), vindesine (3 mg/m2 IV on days 1 and 8), and cisplatin (60 mg/m2 IV on day 1) with forced diuresis, repeated every 4 weeks (MiViP regimen). One hundred eighty-three patients were evaluable. Six complete and 69 partial responses were documented for an overall response rate of 41% (95% confidence interval, 34% to 50%). In the multivariate analysis the strongest predictors for response were the participating institution and the number of initially involved organ sites. The estimated median time to progression for patients with a complete response, partial response, or stable disease was 155 days (estimated inter-quartile range, 99 to 258 days). In the multivariate analysis the time to progression was significantly associated with the number of involved organ sites (P = 0.041). The estimated median survival time for the 183 evaluable patients was 239 days (estimated inter-quartile range, 137 to 436 days). In univariate and multivariate analyses performance status, number of involved organ sites, pretreatment status with radiation therapy, and participating institution were all significantly associated with survival. The principal toxicities were myelosuppression and nausea and vomiting with 16% of the patients refusing further treatment after a median of four cycles of chemotherapy. In conclusion, the MiViP regimen was an active combination chemotherapy in patients with non-small cell lung cancer in a large trial performed by the SAKK. The prognostic value of the participating institution and the number of organ sites involved by metastatic deposits in non-small cell lung cancer needs further investigation.

Mitomycin C: a clinical update

“…In four reports of the two drug combination of MMC + vindesine the effect of prior chemotherapy was evident since 42/84 (48%) of patients without prior therapy responded compared with 6/53 (11%) with prior therapy (179,180,181,182). A survey of 17 studies of MVP with vindesine (references [183][184][185][186][187][188][189][190][191][192][193][194][195][196][197][198][199] gave an overall response of 459/1290 (36%). The same trends were observed regarding cisplatin dose and prior chemotherapy as seen with vinblastine, but the significance was less marked.…”

Modified Glasgow Prognostic Score predicts survival among advanced non-small cell lung carcinoma patients treated with anti-PD1 agents

“…The number of metastatic sites may represent the ability of the tumour cells to spread to other locations and, thus, to its aggressiveness, leading to treatment resistance [63]. Similarly, more metastatic sites have been associated with circulating tumour cells heterogenicity, which may hinder antitumor response to systemic therapies and reduce survival [64][65][66][67][68]. Specifically, among NSCLC patients treated with ICP, a study accessing the prognostic value of metastatic sites reported a worse PFS in patients with more than one metastatic site [50].…”

Predictive factors for a long-term response duration in non-squamous cell lung cancer patients treated with pemetrexed

“…Additionally, a prospective study by Sanchez et al reported that the numbers of metastatic sites and lesions had prognostic relevance [ 17 ]. Tumor burden has exhibited prognostic relevance for survival irrespective of therapeutic agents, cytotoxic chemotherapy, and use of a tyrosine kinase inhibitor such as gefitinib [ 18 – 20 ]. Zhao et al, reported that cancer cells can tolerate chemotherapy and acquire more stemness under hypoxic conditions [ 21 ].…”