Four-drug combination chemotherapy in advanced lung cancer: methotrexate, doxorubicin, cyclophosphamide and CCNU.

One-hundred-twenty patients with advanced lung cancer were treated by the MACC (methotrexate, doxorubicin (Adriamycin), cyclophosphamide and CCNU) regimen. Ninety-eight patients were evaluated. Objective complete response occurred in one case for 27+ months. Partial response was observed in 20 patients lasting for a median of 4.7 months. The overall objective response rate was 21% and the median duration of response was 5.5 months. Stable disease was noted in 44 patients with a median time to progression of 4.7 months from the start of treatment. Tumor progression occurred in 33 cases. There was a significant prolongation of median actuarial survival of responders (11.2 months) vs. stable disease (6.2 months) or vs. non-responders (3.8 months, P less than 0.05). The median actuarial survival for the whole group was 7.3 months. Bone marrow toxicity including thrombocytopenia (less than 100,000 cells/mm3) occurred in 16 patients and leukopenia (less than 3000 cells/mm3) in 24 patients. Forty-seven patients had no hematologic toxicity. Other adverse reactions were nausea and vomiting (50%), stomatitis (16%), alopecia (5%), cardiotoxicity (1%) and fever during leukopenia (1%).