Urokinase combination chemotherapy in small cell lung cancer. A phase II study

✍ Scribed by F. A. Calvo; O. F. Hidalgo; F. Gonzalez; J. Rebollo; S. Martin Algarra; D. Ortiz De Urbina; A. Brugarolas

• Publisher: John Wiley and Sons
• Year: 1992
• Tongue: English
• Weight: 770 KB
• Volume: 70
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19921201)70:11<2624::aid-cncr2820701110>3.0.co;2-4

✦ Synopsis

Background and methods:

Fifty-one patients with small cell lung cancer (sclc) were treated with alternating urokinase (uk)-cyclophosphamide-doxorubicin (adriamycin, adria laboratories, columbus, oh)-vincristine and cisplatin-etoposide-vincristine. uk was given as a loading dose of 3000 micrograms/kg body weight, followed by 3000 micrograms/kg/h for 6 hours. thoracic irradiation with split technique (46 gy) and prophylactic cranial irradiation (25 gy) were administered to responding patients. a second staging was performed in patients exhibiting a clinical complete response (cr) after 1 year.

Results:

In 27 patients with limited disease, there were 23 cr and 8 partial responses (pr) (cr, 85.1%; 66.2-95.8% at 95% confidence intervals); in 24 patients with extensive disease, there were 17 cr, 4 pr, and 3 cases with progression. pathologically proven cr were observed in 59.2% patients with limited disease and 33.3% patients with extensive disease. survival rates were as follows: in patients with limited disease, 1 year, 85.1%; 2 years, 55.5%; and 3 years, 25.9%; in patients with extensive disease, 1 year, 54.1; and 2 years, 16.9%. median survival times were 26.3 months (patients with limited disease) and 13.3 months (patients with extensive disease). uk-related toxic effects included four episodes of mild to moderate bleeding, one allergic reaction, and one cerebrovascular accident. myelotoxicity was severe, with a median of two episodes of grade iii-iv (world health organization classification) aplasia per patient.

Conclusions:

These results are consistent with a potential benefit of fibrinolytic therapy in combination with chemotherapy in patients with sclc with limited disease. additional trials are indicated.