Journal of Clinical Oncology, Vol 6, 5-8, Copyright © 1988 by American Society of Clinical Oncology
A randomized comparative trial of sequential versus alternating cyclophosphamide, doxorubicin, and cisplatin and mitomycin, lomustine, and methotrexate in metastatic non-small-cell lung cancer
RT Eagan, S Frytak, RL Richardson, ET Creagan, TM Therneau, DT Coles and JR Jett
Division of Medical Oncology, Mayo Clinic, Rochester, MN 55905.
One hundred eight eligible patients with advanced, metastatic non-small-
cell lung cancer (NSCLC) were randomized to treatment with either
cyclophosphamide, doxorubicin, and cisplatin (CAP) followed by mitomycin,
lomustine, and methotrexate (MCM) on progression (sequential, 54 patients)
or to CAP alternating with MCM (alternating, 54 patients). The regression
rate (30%) was identical for both treatments. In addition, there were no
statistically significant differences noted between treatments for
regression duration (6.9 months v 7.6 months), time to progression (2.1
months v 4.4 months), or overall survival (5.5 months v 6.9 months). The
lack of advantage for the theoretically superior alternating approach was
probably due to a combination of relative ineffectiveness of each treatment
and lack of complete non-cross resistance.
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