Preliminary clinical study of prednimustine in lung cancer

Prednimustine is a prednisolone ester of chlorambucil which has been found effective in a variety of tumors. Eleven patients with advanced carcinoma of the lung (5 adenocarcinoma, 3 squamous cell carcinoma, 2 small cell carcinoma and 1 large cell carcinoma) were treated at a dosage of 40 mg. per day. Nine had previously failed on combination chemotherapy. No objective responses were observed. Leukopenia or thrombocytopenia were found in 4 patients with nadirs of 2,000 WBC and 60,000 platelets. The lack of response may be a function of the inability of lung carcinoma to concentrate the drug as shown with radioactive labeled Prednimustine. The malignant cells may lose their glucocorticoid binding capacity normally present in the lung. Determination of glucocorticoid binding capacity or Prednimustine uptake might predict the effectiveness of Prednimustine in the treatment of tumor. Prednimustine was well tolerated and may be given safely in advanced malignancies. Further studies with high intermittent doses and selection of tumors with steroid binding properties are now in progress.