Vincristine treatment of advanced cancer: a cooperative study of 392 cases.

Abstract

SUMMARY Vincristine was studied in a series of dose levels in 392 patients with advanced cancer. It produced tumor regres sions in a substantial proportion of patients with advanced lymphosarcoma, reticulum cell sarcoma, Hodgkin's dis ease, breast cancer, bladder cancer, and carcinomas of un known primary site. Response occurred about as frequently at 25 jug/kg/week as at higher doses. Maximum response rates occurred in those patients who sustained moderate toxicity as contrasted to those with only mild or no toxic effects or to those with severe manifestations of drug effect on normal tissues. Dose-related sensory, motor, and auto nomie neuropathy and central nervous system dysfunc tions were observed. Leukopenia and thrombocytopenia were observed. The frequency of responses achieved and their duration were modified by good- or poor-risk status of the patients. Prediction of survival was rather accurate as determined by comparison of prognostication and actual survival times. Responders survived longer than nonresponders. In pa tients with breast cancer, the survival extension beyond prediction cannot be explained as due solely to vincristineinduced remission time. In some other diseases, therapeu tic response to vincristine was able to overbalance a poor prognosis and apparently to increase survival beyond that predicted.