Mitomycin-vindesine-platin (MVP) plus chemoradiotherapy (CR) for primary inoperable non small cell lung cancer (NSCLC)

189 732 MITOMYCIN-VINDESINE-PLATIN (MVP) PLUS CIIEMORADIOTIIERAPY (CR) FOR PRIMARY INOPERABLE NON SMALL CELL LUNG CANCER (NSCLCI. J-LREBISCIIUNG, J-M.VANNE’IZEL, J.SAUVAGET and the GEARC. Hepital Saint-Joseph, Paris, France. Preoperative chemoradiotherapy induces response rates of 86% and 69% for stages 3A and 3B initially inoperable NSCLC. Only 7 of 21 secondary resected patients were pTON0, with 10% local relapses, 33% of metastatic progression and survival at 2 and 4 years of 50 and 30% (ASCO 1991 - Abs.874). We therefore conduct a Phase 2 trial from September 90 to September 91, of pre-operative treatment intensification with 2 or 3 cycles of MVP followed by SFU-CDDP-radiotherapy (40 Gy ; 16 E ; 6 weeks). Among 10 evahrable patients with median follow-up 2 years (5 3A, S 3B), clinical response rate was 100%. One month after completion of the treatment, 4 lobectomies and 6 pneumonectomies have been performed, with 4 pTON0. One postoperative death, 1 local relapse and 3 early metastatic progressions have been registred. Survival rates at 1 and 2 years are 90 and 70%. In conclusion, adjunction of systemic chemotherapy to CR for primary inoperable NSCLC increase the clinical responses even for Stage 3B, don’t modify the histological control rates (7/21 vs 4/10), but the survival at 1 (90 vs 65%) and 2 (70 vs SO%) years by reduction of late metastasis. A randomized trial comparing 2 cycles of Mvp to h4VF’ plus chemoradiotherapy is ungoing.