Single-agent and combination chemotherapy for extensive non-small cell carcinomas of the lung

One hundred and twenty-four patients with extensive bronchogenic carcinoma were randomized to one of three chemotherapeutic regimens. Forty-one patients received cyclophosphamide (600 mg/m2 every 3 weeks) (group 1); 47 patients received cyclophosphamide (600 mg/m2 every 3 weeks) and CCNU (70 mg/m2 every 6 weeks) (group 2); and 36 patients received cyclophosphamide (600 mg/m2 every 3 weeks), CCNU (70 mg/m2 every 6 weeks), and doxorubicin (40 mg/m2 every 3 weeks) (group 3). The objective response rates were 5%, 8%, and 6% in groups 1, 2, and 3, respectively (P greater than or equal to 0.3). Median survival times were 20.5 months (group 1), 17.8 months (group 2), and 18.8 months (group 3). There was no significant difference in median survival between groups (P greater than or equal to 0.4). Responders in each group survived longer than nonresponders. Hematologic toxic effects were severe in group 3 and moderate in group 2. Since combination chemotherapy with cyclophosphamide and doxorubicin or cyclophosphamide, doxorubicin, and CCNU is not superior to cyclophosphamide as a single agent and is associated with greater toxicity, these combinations are not recommended as therapy for extensive bronchogenic carcinoma.