[Randomized study of cisplatin and doxorubicin with or without vincristine in non-small cell lung cancer].

A randomized study of anticancer chemotherapy, CDDP plus ADM with/without VCR on patients with NSCLC was carried out. Forty-six patients received injections of CDDP (75 mg/m2) and ADM (50 mg/m2) every 4 weeks (Regimen A); 39 patients were injected with the same doses of CDDP and ADM, plus VCR (1.4 mg/m2, on day 1 and 0.7 mg/m2, on day 7), every 4 weeks (Regimen B). Seven patients (15%) and 10 patients (26%) achieved a partial response by Regimens A and B, respectively. The median survival time (MST) was 8.5 months in each group. Survival time of the responders (MST; 27 months) was much more prolonged than that of the non-responders (MST; 7 months) (p less than 0.01). Both regimens were well tolerated with only moderate gastrointestinal symptoms and mild bone marrow toxicities. Although the addition of VCR to CDDP plus ADR in NSCLC fulfilled the objective tumor regression, no additive effect could be obtained with regard to survival.

[Combination chemotherapy for small cell carcinoma of the lung: AVN-DVC therapy].

Comparative studies of alternating non-cross resistant chemotherapy, A.V.N.-D.V.C. (ACNU + VCR + PCZ-ADM + VCR + CPA) was carried out on 19 patients with small cell lung cancer. A.V.N. (A. V.F.) therapy on 45 patients and D.V.C. therapy on 19 patients were used as historical control, respectively. A.V.N. (A.V.F.) therapy was composed of ACNU (2.5 mg/kg, day 1), VCR (0.02 mg/kg, once every week) and PCZ (1 mg/kg, daily) (or FT-207 (15 mg/kg, daily], and duration of one course was 6 to 8 weeks. D.V.C. therapy was composed of ADM (1 mg/kg, day 1) VCR (0.02 mg/kg, days 1 and 5) and CPA (2 mg/kg, days 1 to 5), and repeated every 4 weeks. A.V.N.-D.V.C. therapy was done by a timely alternation of one course of A.V.N. and two course of D.V.C. Reduction rate of tumor size was 84% in A.V.N.-D.V.C. therapy, 62% in A.V.N. (A.V.F.) therapy and 26% in D.V.C. therapy, respectively. Median survival time was 13 months on A.V.N.-D.N.C. therapy, 8.5 months and A.V.N. (A. V.F.) therapy and 4 months on D.V.C. therapy. Significant prolongation of median survival time was obtained in A.V.N.-D.V.C. therapy in comparison with that of historical controls. Major toxicity in A.V.N.-D.V.C. therapy was slight bone marrow suppression.

Glucocorticoid receptors in bronchoalveolar cells from patients with idiopathic pulmonary fibrosis.

In order to clarify the physiologic and clinical significances of glucocorticoid receptors in bronchoalveolar cells, we measured the glucocorticoid receptor content in bronchoalveolar cells obtained from patients with idiopathic pulmonary fibrosis (IPF), normal volunteers, control patients with localized lung cancer, and a group of patients with pulmonary manifestations associated with collagen-vascular diseases, hypersensitivity pneumonitis, pneumoconiosis, and chronic bronchitis. The contents of glucocorticoid receptors in bronchoalveolar cells from patients with IPF (5,561 +/- 3,741 sites per cell) and various pulmonary diseases (4,452 +/- 2,097 sites per cell) were lower than those in bronchoalveolar cells from normal volunteers (9,970 +/- 4,050 sites per cell) and control patients (8,354 +/- 4,367 sites per cell). Patients with IPF, who had a lower glucocorticoid receptor content in bronchoalveolar cells did not respond to glucocorticoids. On the contrary, the patients with IPF who responded well to glucocorticoids had as much glucocorticoid receptor content in bronchoalveolar cells as normal volunteers had. These results suggested that the content of glucocorticoid receptors in bronchoalveolar cells varies during disorders of the lung, and may be a useful parameter for predicting whether glucocorticoid therapy will be effective in IPF.