VP-16 and cisplatin in the treatment of non-small-cell lung cancer.

The EORTC Lung Cancer Working Party investigated the effects of combination therapy with VP-16 (Ve-Pesid) and cisplatin in the treatment of non-small-cell lung cancer (NSCLC). Neither agent alone is recognized as being associated with a high rate of response in NSCLC, but the combination proved beneficial in our hands and effected a total response rate (including complete and partial responses) of over 40%. In addition to this encouraging result, complete remissions occurred in a modest number of patients. The addition of vindesine to the regimen profferred no benefit, but did increase the incidence of toxic reactions. Preliminary data on supraconventional dosages of cisplatin indicate a trend toward better response and longer survival but a significantly higher frequency of severe leukopenia as well. No studies have yet been conducted with higher doses of VP-16 in NSCLC patients, but related investigations into the treatment of small-cell bronchogenic carcinoma indicated that doses up to 3 g/m2 of VP-16 were well tolerated by patients. It is cautiously concluded that the combination of cisplatin and VP-16 probably offers an advantage over single-drug therapy with either agent alone in the treatment of non-small-cell lung cancer.