Advanced Lung Cancer Treated with Cyclophosphamide

Seventy-eight patients with locally recurrent or disseminated lung cancer were treated with cyclophosphamide therapy. Only eight patients showed objective tumor regression. Five of the objective responses occurred in patients with small cell anaplastic carcinoma and three in patients with squamous carcinoma. No objective responses were seen in adenocarcinoma or alveolar cell carcinoma. An additional 26 patients manifested a stable or subjectively improved status during therapy. Hemorrhagic cystitis was seen in six of 36 patients receiving the drug orally but in none of those receiving monthly intravenous courses. Hematologic toxicity was acceptable though there was one death from sepsis associated with leukopenia. There was no evidence that life was prolonged by this drug. Because there seemed to be frequent subjective benefit, we recommend that symptomatic patients with recurrent or disseminated lung cancer receive monthly intravenous courses of cyclophosphamide as palliative therapy.