A pilot study of MVP (mitomycin-C, vinblastine and cisplatin) chemotherapy in small-cell lung cancer
A pilot study of MVP (mitomycin-C, vinblastine and cisplatin) chemotherapy in small-cell lung cancer
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DOI：
10.1038/bjc.1998.326
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发表时间：
1998-06-01
影响因子：
8.8
通讯作者：
O'Brien, MER
中科院分区：
文献类型：
--
作者：
Hickish, TF;Smith, IE;O'Brien, MER
MVP方案（丝裂霉素C8 mgm（-2），疗程1、2、4、6，长春碱6 mgm（-2），顺铂50 mgm（-2））是治疗非小细胞肺癌（NSCLC）的有效低毒性方案。基于这些药物在SOLO中的单药活性，我们进行了MVP在SOLO中的II期试验。50例未经化疗的SOLO患者入组本试验。有33名男性和17名女性，中位年龄66岁（范围46-83岁）; 18名患者患有局限性疾病（LD）和32名广泛性疾病（艾德）。WHO体力状态（PS）为：3例患者PS 0，33例患者PS 1，10例患者PS 2，4例患者PS 3。在有反应的患者中最多给予6个周期。化疗完成后，获得完全缓解（CR）/良好部分缓解（PR）的LD患者接受胸部放疗，获得CR的患者可进入正在进行的MRC预防性颅脑放疗试验。总有效率为79%，其中CR为17%，PR为62%。LD患者中，38%获得CR，但艾德仅1例获得CR。LD患者的中位缓解持续时间为8个月，艾德患者为5个月。LD患者的中位生存期为10个月，艾德患者为6个月。24%的患者症状完全缓解，68%的患者部分改善，2%的患者无变化，6%的患者症状进展。至于毒性，24%发生WHO 3/4级中性粒细胞减少症，16%发生3/4级血小板减少症，6%发生严重脱发。两名患者在治疗的第一周死于血小板减少性感染。使用EORTC问卷（QLC-C30）和肺癌模块的生活质量显示，疼痛、呼吸困难和咳嗽的情绪和认知功能、总体QOL较基线水平显著改善。MVP是一种有效的NSCLC姑息治疗方案，对SOLO也有活性，毒性低，与毒性更大的常规方案相比具有优势。
MVP chemotherapy (mitomycin C 8 mgm(-2), courses 1,2,4 and 6, vinblastine 6 mgm(-2), cisplatin 50 mgm(-2)) is an active low-toxicity regimen in non-small-cell lung cancer (NSCLC). Based on the single-agent activity of these agents in SOLO, we have conducted a phase II trial of MVP in SOLO. Fifty chemo-naive patients with SOLO were entered in this trial. There were 33 men and 17 women with median age 66 years (range 46-83 years); 18 patients had limited disease (LD) and 32 extensive disease (ED). WHO performance status (PS) was: three patients PS 0, 33 patients PS 1, ten patients PS 2, four patients PS 3. A maximum of six cycles was given in responding patients. On completion of chemotherapy, patients with LD obtaining complete response (CR)/good partial response (PR) received thoracic irradiation and those obtaining CR were offered entry into the ongoing MRC Prophylactic Cranial Irradiation Trial. The overall response was 79% with 17% CR and 62% PR. For LD patients, 38% obtained CR but for ED only one patient achieved CR. Median response duration for LD patients was 8 months and for ED patients 5 months. Median survival was 10 months for LD patients and 6 months for ED patients. There was complete resolution of symptoms in 24%, partial improvement in 68%, no change in 2% and progressive symptoms in 6%. As regards toxicity, 24% developed WHO grade 3/4 neutropenia, 16% grade 3/4 thrombocytopenia and 6% significant hair loss. Two patients died during the first week of treatment with neutropenic infection. Quality of life using the EORTC questionnaire (QLC-C30) with lung cancer module demonstrated significant improvements from baseline levels in emotional and cognitive functioning, global QOL, of pain, dyspnoea and cough. MVP, an effective palliative regimen for NSCLC, is also active against SOLO with low toxicity and merits comparison with more toxic conventional schedules.