Intensive cytosine arabinoside therapy in small cell carcinoma of the lung.

Cytosine arabinoside (Ara-C) 100 mg/m2/d was given by continuous infusion to patients with small cell carcinoma of the lung in two simultaneous studies. In a first study, 10 patients who had failed prior therapy were treated with Ara-C alone. No responses were seen in these heavily pretreated patients and toxicity was severe. In a second study, Ara-C was added to the known active combination of cyclophosphamide, adriamycin, and vincristine (CAV) in 25 patients with extensive-stage small cell carcinoma with no prior treatment. Despite a clinical response rate of 52% (28% complete remissions, 24% partial remissions), the median survival was 169 days. This aggressive therapy approach produced substantial toxicity and no therapeutic benefit over previous regimens. Continuous infusion Ara-C (100 mg/m2/d X 3 days) used alone, or combined with CAV is not a useful agent for cell carcinoma of the lung.