High dose combination chemotherapy with ifosfamide, cyclophosphamide or cisplatin, mitomycin C and mustine with autologous bone marrow support in advanced non-small cell lung cancer. A phase I/II study

Abstract

Summary Twenty-three patients with advanced NSCLC were treated with high dose chemotherapy using four agents and autologous bone marrow reinfusion. Ten patients received two bolus doses of cyclophosphamide (maximum tolerated total dose 10 G m 2), ifosfamide as a 24 h infusion (11 G m-2) followed by mitomycin C (70 mg m 2) as a subsequent 24 h infusion and mustine as two boluses (total dose 30 mg m 2). Another 13 patients received the same agents except cisplatin was substituted for cyclophosphamide, two doses (total dose 100 mg m 2) being given in a 24 h period. The

High-dose chemotherapy with peripheral blood progenitor cell support for patients with non-small cell lung cancer: the experience of the European Group for Bone Marrow Transplantation (EBMT) Solid Tumours Working Party

“…The authors stressed that regardless of the outcome of this study, large phase III trials will be needed to further define the role of HDC in NSCLC. 12 In a phase II study on HDCT in NSCLC, Fletscher et al 14 enrolled 27 patients who received an HDCT course cycle consisting of etoposide 1500 mg/m 2 , ifosfamide 12 000 mg/m 2 , carboplatin 750 mg/m 2 and epirubicin 150 mg/m 2 followed by PBPCs after achieving a remission with two cycles of standard-dose induction chemotherapy with etoposide, ifosfamide, cisplatin and epirubicin. No advantage was observed with a 5-year survival of 0% in stage IV patients.…”

“…13 The Cancer and Leukemia Group B conducted a pilot study that consisted of two cycles of paclitaxel (250 mg/m 2 ) and carboplatin (AUC 18) supported by PBPCs in patients with locally advanced NSCLC. 12 Patients achieving a response to this induction treatment underwent surgical resection, thoracic radiation or both. This feasibility study examined clinical and pathologic responses to the toxic effects of this HDC regimen in locally advanced NSCLC.…”

“…[7][8][9] In the past years, several attempts have been made to improve the outcome of NSCLC patients, including the use of HDCT with PBPC in first-line setting, but only few case series have been reported in the literature. [10][11][12][13] To better characterize this issue, we reviewed the database of the patients registered with the European Group for Blood and Marrow Transplantation (EBMT) for HDCT with PBPCs in patients with NSCLC and analyzed survival data.…”

Effective removal of SCLC cells from human bone marrow. Use of four monoclonal antibodies and immunomagnetic beads

“…High dose chemotherapy followed by ABMT in SCLC patients has been used by several investigators (Humblet et al, 1987;Symann et al, 1989;Souhami et al, 1989;Williams et al, 1989;Marangolo et al, 1989;Nomura et al, 1990;Lazarus et al, 1990;Gomm et al, 1991) Berendsen et al, 1988;Canon et al, 1988;Trillet et al, 1989;Beiske et al, 1992). It should also be noted that the detection of tumour cells in bone marrow is based on studies of small volume aspirates, whereas about 11 of bone marrow is harvested for ABMT.…”

“…To improve the situation, autologous bone marrow transplantation (ABMT) combined with high dose chemotherapy has been tried (Humblet et al, 1987;Symann et al, 1989;Souhami et al, 1989;Williams et al, 1989;Marangolo et al, 1989;Nomura et al, 1990;Lazarus et al, 1990;Gomm et al, 1991). This treatment has increased the number of patients with complete remissions (Humblet et al, 1987;Souhami et al, 1989) and improved relapse free-survival (Humblet et al, 1987;Symann et al, 1989), but, unfortunately, the long time survival rate has not increased significantly.…”