5-Fluorouracil, Adriamycin, and Mitomycin-C (FAM) in the Treatment of Inoperable Adenocarcinoma of the Lung

Fifty-three patients with inoperable adenocarcinoma of the lung were treated with 5-fluorouracil, Adriamycin, and mitomycin-C (FAM) in two dose schedules: schedule 1--5-FU 600 mg/m2 days 1, 8, 29, and 36 and Adriamycin 30 mg/m2 days 1 and 29 and mitomycin-C 10 mg/m2 day 1 repeated every 8 weeks. Schedule 2--5-FU 600 mg/m2 and Adriamycin 30 mg/m2 days 1 and 22 and mitomycin-C 10 mg/m2 day 1, repeated every 6 weeks. There were 28 males and 25 females, median age 57 years. There were 11 patients with limited disease and 42 patients with extensive disease. Ten patients had ECOG performance status 0; 34, 1; 6, 2; and 3, 3. Ten patients (18.8%) achieved a partial response. Response was seen in four limited disease patients (36.3%) and only six extensive disease patients (11.9%). The median duration of response was 33 weeks (range 17-50 weeks), and the median survival of these patients was 89.7 weeks. Sixteen patients achieved stable disease with a median response duration of 22 weeks (range 8-91 weeks). The median survival of the entire group was 32.6 weeks. The FAM regimen was tolerated well, with only mild gastrointestinal symptoms and moderate myelosuppression. The granulocyte nadir was less than 1,000 in 8% of patients and 1,000-1,500 in 20%. Only 5% of patients had a platelet count under 100,000 and three patients required red cell transfusions during treatment. These results indicate that FAM chemotherapy may be administered as an outpatient with minimal toxicity and can cause objective tumor regression in patients with adenocarcinoma of the lung.