A pilot study of MVP (mitomycin-C, vinblastine and cisplatin) chemotherapyin small-cell lung cancer

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-sm all-cell lung cancer (NSCLC). Based on the single-agent activity of these a gents in SOLO, we have conducted a phase II trial of MVP in SOLO. Fifty che mo-naive patients with SOLO were entered in this trial. There were 33 men a nd 17 women with median age 66 years (range 46-83 years); 18 patients had l imited 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 pat ients PS 3. A maximum of six cycles was given in responding patients. On co mpletion of chemotherapy, patients with LD obtaining complete response (CR) /good partial response (PR) received thoracic irradiation and those obtaini ng CR were offered entry into the ongoing MRC Prophylactic Cranial Irradiat ion Trial. The overall response was 79% with 17% CR and 62% PR. For LD pati ents, 38% obtained CR but for ED only one patient achieved CR. Median respo nse duration for LD patients was 8 months and for ED patients 5 months. Med ian survival was 10 months for LD patients and 6 months for ED patients. Th ere was complete resolution of symptoms in 24%, partial improvement in 68%, no change in 2% and progressive symptoms in 6%. As regards toxicity, 24% d eveloped WHO grade 3/4 neutropenia, 16% grade 3/4 thrombocytopenia and 6% s ignificant 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 pai n, dyspnoea and cough. MVP, an effective palliative regimen for NSCLC, is a lso active against SOLO with low toxicity and merits comparison with more t oxic conventional schedules.