A phase II trial of combination chemotherapy in patients with metastatic carcinoid tumors. A southwest oncology group study

Abstract

A prospective Phase II trial of combination chemotherapy in patients with metastatic carcinoid tumors was conducted by the Southwest Oncology Group. The therapy included 5‐fluorouracil, Adriamycin, cyclophosphamide, and streptozotocin (FAC‐S) or the same combination without Adriamycin (FC‐S) in patients with heart disease. Seventy‐four patients were entered and two were ineligible. Sixty‐nine of the 72 were histologically reviewed. Six patients were declared ineligible after this review. Fifty‐six patients received FAC‐S, and nine received FC‐S (one patient was inevaluable). The response rates were 31% and 22%, respectively. The median survival of all patients was 10.8 months. The analyses of various clinical and histologic parameters indicated that responses were more common in patients with gastrintestinal carcinoids; there was also a tendency toward shorter survival in patients with tumors that had a higher mitotic rate or the atypical and/or undifferentiated histologic pattern. The FAC‐S combination can produce objective responses in patients with metastatic carcinoid tumors, but these are generally partial and brief. It was also concluded that currently available chemotherapy is inadequate.