LUNG SPECIFIC CHEMO
Cancer Treatment Review, 1983 Sep;10(3):159-72.
Chemotherapy of non-small cell lung cancer: a reappraisal and a look to the future.
Bakowski MT, Crouch JC.
“A reappraisal of the position of both radiotherapy and chemotherapy in the treatment of the disease is of high priority…The question of whether chemotherapy can favorably influence the quality of life of patients with NSCLC [Non Small Cell Lung Cancer] therefore remains to be answered…The objective of these studies must, in the final analysis, be to relieve suffering. Even if chemotherapy cannot offer hope of a cure, palliation must surely be a worthwhile goal.”
Cancer, 1986 Sep 15;58(6):1193-8. Long-term survival in limited-stage small cell lung carcinoma. By: George et al.
A 100 patient evaluation on Non Small Cell Lung Carcinoma.
“Response rate and survival did not correlate with any drug or drug combination…There was no evidence for significantly improved survival during the 6 year period of our study in Rochester… with only a modest percentage of remissions, the incapability of long-term palliatives (contained action of symptoms), and a very modest number of survivors after 2-3 years, even in patients treated at the initial stage of the illness, no treatment with Chemo can be considered a standard in dealing with small-cell lung carcinoma…”
Also published in Lung Cancer, September 1987, Volume 3, Issue 2, Page 103
Clinical Cancer Research, 2004 Jul 1;10(13):4369-73.
Uracil/tegafur plus cisplatin with concurrent radiotherapy for locally advanced non-small-cell lung cancer: a multi-institutional phase II trial. By: Ichinose Y1, Nakai Y, Kudoh S, Semba H, Yoshida S, Nukiwa T, Yamamoto H, Yamane Y, Niitani H.
“Seventy patients were enrolled and eligible, as follows: 57 males/13 females..A complete response was observed in two patients.”
Lung Cancer, 2004 Aug;45(2):255-62.
Phase II study of docetaxel and carboplatin as second-line treatment in NSCLC.
Wachters FM1, van Putten JW, Boezen HM, Groen HJ.
The aim of this Dutch study was to evaluate activity and toxicity of docetaxel and carboplatin in advanced non-small-cell lung cancer (NSCLC) patients. The study considered 57 patients undergoing Chemotherapy without Radiotherapy. From January 1999 until June 2001, 57 patients were included. 50% of patients were still alive after about 4 months, after one year only 32% were alive and by December 2002 all patients had died.
Dr. Jean Klastersky, M.D., Professor, University of Brussels, Chief of Medicine Service
of the Department of Internal Medicine at Institut Jules Bordet, which is a general hospital and research institute of the Université Libre de Bruxelles which specializes in oncology. It is located in Brussels, Belgium. At the proceedings of a satellite symposium of the 7th World Conference on Lung Cancer held June 27, 1994, in Colorado Springs, CO, Dr. Klastersky presented , “Small cell lung cancer: can treatment results be improved further?”, which was published in Seminars in oncology, 22(1), 1995, pp. 1-2
During the previous ten years, Dr. Klastersky summarized the most important studies that had been carried out: “…recently, a number of different chemotherapy regimes have been tried, in the hope of improving the results by increasing the intensity of the dose. All of these efforts, from the extreme (Chemotherapy with bone-marrow transplant) to the simplest (doubling of doses), have failed. No significant result has been obtained by increasing the chemotherapy doses in the treatment of small-cell bronchial carcinoma, nor has any improvement been noted through the combination of single agents.”
Cancer Control, 1997 Jul;4(4):317-325.
New Agents in the Management of Non-Small Cell Lung Cancer.
By: Chiappori A, DeVore RF, Johnson DH.
“Non-small-cell carcinoma of the lung has long been considered a chemotherapeutically resistant neoplasm.”
The New England Journal of Medicine, 2002, Four Chemotherapy Regimens for Advanced Non-Small Cell Lung Cancer; 346: pages 92-98 January, 2002. By: Schiller, et al. A study utilizing four of the newer chemotherapy regimens was conducted on 1207 patients with advanced non–small-cell lung cancer. The drugs produced a two-year survival rate of 11% and substantial toxicity. It was concluded that:
“None of four chemotherapy regimens offered a significant advantage over the others in the treatment of advanced non–small-cell lung cancer.”
Lung Cancer, 2003, 39:55-61
A retrospective analysis of the outcome of patients who have received two prior chemotherapy regimens including platinum and docetaxel for recurrent non-small-cell lung cancer. By: Massarelli E, Andre F, Liu DD, et al.
The available data for NSCLC show a documented response rate of only 2% for third-line and 0% for fourth-line chemotherapy in the largest series at MD Anderson Cancer Center. Despite the evidence for lack of effect, n-th line chemotherapy is common.
The New England Journal of Medicine, 2012; 367:1616-1625
Patients’ Expectations about Effects of Chemotherapy for Advanced Cancer
By: Weeks et al. “Chemotherapy for metastatic lung or colorectal cancer can prolong life by weeks or months and may provide palliation, but it is not curative.” It continues with,
“Should we be concerned that the majority of patients with these diseases provide responses suggesting that they do not understand that there is essentially no chance that the chemotherapy they are receiving will cure them?”
The January 10, 2002 issue of The New England Journal of Medicine, Vol. 346, No. 2, in the editorial entitled: LUNG CANCER— TIME TO MOVE ON FROM CHEMOTHERAPY, it states “During the past 20 years, numerous efforts have been made to reduce the death rate among patients with lung cancer. Yet after 20 years, the improvement in long-term survival has been slight…the benefits of combination chemotherapy among the fittest patients with advanced non–small-cell lung cancer are marginal (with perhaps a gain in median survival of two to three months)…Chemotherapy in advanced lung cancer has reached a plateau; there are few differences among various combinations of drugs.” and lastly “The current treatment of advanced small-cell and non–small-cell lung cancer with combination chemotherapy is nonspecific, nonselective, and toxic. New combinations of chemotherapy are not likely to make substantial improvements in survival. 20 years of chemotherapy clinical trials on advanced lung cancer have yielded survival improvement of only two months.”