CCNU, vincristine, methotrexate, and procarbazine treatment of relapsed small cell lung carcinoma

Thirty-two patients with refractory relapsed small cell carcinoma of the lung (SCCL) were treated with a combination of CCNU (lomustine), vincristine, methotrexate, and procarbazine (COMP); 29 were evaluable for response. Nine patients (31%) had responses: five complete responses (CR) and four partial responses. Patients with CR had a median survival of 11 months (range, 51/2-141/2) from the start of COMP. Patients with less than CR had a median survival of approximately 3 months (range, less than 1-7). The comparison of CR versus less than CR is significant (P = 0.003). Patients achieving CR usually had limited disease and four of the five who achieved CR survived greater than 6 months. The regimen was well-tolerated, but myelosuppression was seen in all patients. COMP appears to be a useful combination in patients with relapsed SCCL. Aggressive retreatment should be considered in relapsed patients with this disease since some may achieve a second CR, with the associated potential survival benefit.