Mitomycin-C, etoposide, cisplatin, and hexamethylmelamine (MEPH) as a second-line regimen in lung cancer

Abstract

Fifty-three patients with advanced lung cancer refractory to chemotherapy with MACC (methotrexate, adriamycin, cyclophosphamide, and CCNU [1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea]) were treated with a combination of mitomycin-C, etoposide, cisplatin, and hexamethylmelamine (MEPH). Among 45 evaluable patients, there were 7 partial responders (16%), including 2/18 adenocarcinomas, 3/13 small cell anaplastic carcinomas, 1/5 large cell anaplastic carcinomas and 1/9 squamous cell carcinomas. Major toxic side effects included thrombocytopenia (30/45 patients), leukopenia (22/45 patients) and emesis. Renal toxicity occurred in 3 patients, and cardiac arrythmia was observed in 1 patient. Despite a low response rate, which was expected in this group of heavily pretreated patients with poor prognostic characteristics, a lack of cross-resistance between MEPH and MACC is suggested.