A phase II trial of fotemustine and cisplatin in central nervous system metastases from non-small cell lung cancer

• Published in: European journal of cancer (1990) Vol. 32; no. 1; pp. 69 - 71
• Main Authors: Cotto, C., Berille, J., Souquet, P.J., Riou, R., Croisile, B., Turjman, F., Giroux, B., Brune, J., Trillet-Lenoir, V.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 1996
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Brain Neoplasms - drug therapy; Brain Neoplasms - secondary; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - secondary; central nervous system metastases; chemotherapy; cisplatin; Cisplatin - administration & dosage; Cisplatin - adverse effects; Female; fotemustine; Hematologic Diseases - chemically induced; Humans; Lung Neoplasms - pathology; Male; Middle Aged; Nitrosourea Compounds - administration & dosage; Nitrosourea Compounds - adverse effects; non-small cell lung cancer; Organophosphorus Compounds - administration & dosage; Organophosphorus Compounds - adverse effects; Survival Rate; non-small cell lung cancer; fotemustine; cisplatin; central nervous system metastases; chemotherapy
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/0959-8049(95)00507-2

A phase II study was conducted in order to determine the feasibility and toxicity of cisplatin combined with the nitrosourea fotemustine in central nervous system metastases from non-small cell lung cancer. 31 chemotherapynaive patients were included between November 1990 and April 1993. Computed tomography scan-documented tumour regression in brain metastases was observed in 7 of the 25 evaluable patients, but only 4 of these (16%) lasted more than 4 weeks. In 2 of these 4 patients, the response on central nervous system metastases was considered as complete. The median duration of response was 20.5 weeks and the median survival was 16 weeks overall and 28.5 weeks for responding patients. The limiting toxicity of this regimen was haematological. 2 patients died from infectious pneumonitis while in neutropenia. Treatment delays due to haematological toxicity occurred in 57% of patients. Despite the rather encouraging response rate, such toxicity appears too high when compared to the overall bad prognosis of this population of patients. Cranial radiotherapy remains the standard treatment in this setting and should only be compared in the future to less aggressive schedules.