Search

A role for vinblastine (VBL) in lung cancer has never been clearly defined. Because of recent pharmacokinetic data suggesting a biweekly schedule for VBL and recent antitumor activity shown for vindesine, a phase II trial of divided-dose VBL was initiated. Among 22 evaluable patients, a 27% major response rate was seen, with a median duration of 5.5 months (range 3.5-12+). The major toxic effect was myelosuppression but was easily manageable and tolerated. These results suggest schedule dependency for VBL and open the question of its efficacy in lung cancer.

In a phase I study of spirogermanium, a new azaspiran-germanium compound, 28 patients were given a multiple-dose schedule. When infused over 1 hour, the maximum tolerated single dose of this agent was greater than 120 mg/m2 but significant chronic neurologic toxicity occurred after 1-2 weeks of treatment. Patients with a poor performance status (PS) were the most likely to manifest toxic reactions. Suggested phage II dose levels for infusion treatment with spirogermanium are 120 mg/m2 for patients with a PS of 0-2 and 80 mg/m2 for patients with a PS of 3.

A phase II trial of mitomycin, vinblastine, and cisplatin was undertaken in 26 patients with non-small cell carcinoma of the lung. A major response rate of 46% was seen in measurable and evaluable disease, with a complete response rate of 12%. Median duration of response is 6.5+ months (range, 2.5-19+). Toxic effects included moderate myelosuppression, mild neuropathy, mild azotemia, and severe nausea and vomiting. These results are similar to previously reported studies using vinca alkaloids and cisplatin alone.

Vinzolidine is a new, orally active, semisynthetic vinca alkaloid which shows broad anti-tumor activity against murine tumor test systems. This phase I study established a 1 day every 2 week schedule of 35 mg/m2 in good-risk patients and of 30 mg/m2 in poor-risk patients. Maximal tolerated dose was 45 mg/m2 with severe neutropenia, syndrome of inappropriate antidiuretic hormone, and paralytic ileus. Significant antitumor responses were seen in two patients with lymphoma and in one with squamous cell cancer of the lung.