Combination chemotherapy confers modest survival advantage in patients with advanced non-small cell lung cancer: report of a Canadian multicenter randomized trial.

Between February 1983 and January 1986, the National Cancer Institute of Canada conducted a prospective randomized trial comparing best supportive care (BSC) with two chemotherapy regimens: Vindesine and cisplatin (Platinol) (VP) and cyclophosphamide, doxorubicin, and cisplatin (CAP). Twenty-three centers across Canada entered 251 patients on the basis of measurable or evaluable disease, with either distant metastases or bulky limited disease considered inoperable and unsuitable for radical radiation therapy; 233 patients were eligible for evaluation. The overall response rates on the chemotherapy arms were: VP, 25.3%; CAP, 15.3%. The median survival rates were: VP, 32.6 weeks; CAP, 24.7 weeks; BSC, 17 weeks. Toxicity on the chemotherapy arms was significant. Although better therapies are required, the data in this study clearly indicate that VP and CAP combination chemotherapy confers a modest survival advantage over BSC in advanced non-small cell lung cancer.