Section Review: Oncologic, Endocrine & Metabolic: New cytostatic drugs in the treatment of non-small cell lung cancer

Abstract

This article reviews literature published on new cytostatic drugs for the treatment of non-small cell lung cancer, covering the period from January 1993 until June 1995.

Further experience with the nitrosourea derivative fotemustine has demonstrated this compound to be moderately active in NSCLC, with a 19% response rate among 68 previously untreated patients. The activity of the antimetabolite, gemcitabine, has been further documented in two studies, with 20% responders among 155 patients. Results of gemcitabine in combination with cisplatin are awaited. Substantial evidence has accumulated on the activity of the topoi-somerase I inhibitor, CPT-11, which, following documentation of single agent activity, has been tested in various combination chemotherapy regimens. Among these, it is of interest that CPT-11 in combination with cisplatin, with or without vindesine, shows response rates in excess of 40%, although, to date, relatively few patients have been studied (3 studies, 47 patients). Vinorelbine has previously proven active when given intravenously. However, it is of interest that vinorelbine has shown a 15% response rate when administered orally. Combination of vinoreibine together with either cisplatin or carbopiatin has resulted in response rates from 30 - 43% and a 60% response rate has been reported following the addition of ifosfamide. Both of the taxanes, paclitaxel and docetaxel, have proven active as single agents with cumulative response rates of 22% (2 studies, 49 patients) and 30% (4 studies, 125 patients), respectively, among previously untreated patients. Combinations with platinum compounds are in progress.

It is hoped that inclusion of these interesting new agents in treatment regimens for NSCLC will improve the prognosis for this grave disease; such trials should have high priority for clinical researchers.