[Initial results of a controlled study of small cell and squamous epithelial bronchial cancer: polychemotherapy and...

We investigated a combination of polychemotherapy with beta- and gamma-interferon in patients with small cell and squamous cell bronchial carcinoma. Immunological monitoring was designed to detect systemic and local immunomodulatory effects of interferon therapy. Small cell carcinoma was treated every three weeks with adriamycin, cyclophosphamide and vincristine, squamous cell carcinoma was treated every three weeks with mitomycin, vindesine and ifosfamide. In one group of patients polychemotherapy was combined with beta- and gamma-interferon. In the event of no change or tumour progression cisplatin and etoposide were administered. In the case of PR and CR the initial schedule was continued. Treatment was stopped on achieving CR after 6 cycles, or in the case of no response. To date, 40 patients have been evaluated. Results indicate a slight increase in the response rate in patients with small cell carcinoma, extensive disease, in the interferon group, and an unchanged response rate in patients with squamous cell carcinoma. Besides the common "flu-like" symptoms there was considerable myelosuppression in patients under additional interferon therapy. In the interferon group we found measurable gamma-interferon serum levels, an increase in the spontaneous production of IL 2 by peripheral lymphocytes, and an increase in the spontaneous production of IL 1 and an in the phagocytic capacity of monocytes. In contrast, alveolar macrophages as part of local immunity show a decrease in the spontaneous and LPS-induced production of IL-1.