MACC (methotrexate, doxorubicin, cyclophosphamide and lomustine) versus cis-platinum and etoposide in the treatment of advanced non-small cell lung cancer.

From June, 1982 to December, 1984, 35 consecutive patients with histologically proven non-small cell lung cancer (NSCLC) were treated either with methotrexate, adriamycin, cyclophosphamide and CCNU (MACC regimen) or cis-platinum and etoposide (DDP-VP16). The rates of objective responses were, respectively, 15% (3 partial responses out of 20 patients) and 13 (2 out of 15). Times to progression were significantly prolonged in the DDP-VP16 group (median: 29 weeks vs 11), with a trend to improvement in the median survival time (30 weeks vs. 17, P less than 0.1). Except for life-threatening leukopenia in 15% of the MACC patients and intractable vomiting in 47% of patients on cis-platinum based chemotherapy, no serious toxicity was observed. The DDP-VP16 combination seems to be more effective, but less well tolerated, than the MACC regimen and can be recommended for compliant patients with good prognostic factors.