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Vincristine Treatment of Advanced Cancer: A Cooperative Study of 392 Cases¹

Roswell Park Memorial Institute, Buffalo, New York 14203 [J. F. H., C. S., S. G.]; Lemuel Shattuck Hospital, Boston, Massachusetts 02130 [M. J. K.]; Albany Medical College, Albany, New York 12208 [K. B. O., J. H.]; Georgetown University School of Medicine Washington, D. C. 20007 [B. I. S.]; the Veterans Administration Hospital Washington, D. C. 20422 [J. J. L.]; Johns Hopkins Hospital, Baltimore, Maryland 21205 [A. O.]; National Cancer Institute, Bethesda, Maryland 20014 [P. P. C.]; Jackson Memorial Hospital, Miami, Florida 32216 [J. C.]; Maimonides Hospital, Brooklyn, New York 11219 [D. G., S. P. M.]; Pondville Hospital, Walpole, Massachusetts 02081 [J. C. H.]

Vincristine was studied in a series of dose levels in 392 patients with advanced cancer. It produced tumor regressions in a substantial proportion of patients with advanced lymphosarcoma, reticulum cell sarcoma, Hodgkin's disease, breast cancer, bladder cancer, and carcinomas of unknown primary site. Response occurred about as frequently at 25 µg/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 not toxic effects or to those with severe manifestations of drug effect on normal tissues. Dose-related sensory, motor, and autonomic neuropathy and central nervous system dysfunctions 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 patients with breast cancer, the survival extension beyond prediction cannot be explained as due solely to vincristine-induced remission time. In some other diseases, therapeutic response to vincristine was able to overbalance a poor prognosis and apparently to increase survival beyond that predicted.

¹ This study was supported by USPHS research grants from the National Cancer Institute: CA-2821 (J. F. H., C. S., S. G.), CA-07190 (M. J. K.), CA-06594 (K. B. O., J. H.), CA-02824 (B. I. S., J. J. L.), CA-06973 (A. O.), CA-02822 (J. C.), CA-05588 (D. G., S. P. M.), CA-04739 (T. C. H.).

² Present address: National Cancer Institute, Bethesda, Md. 20014.

³ Present address: Physicians Office Building, Washington, D. C.

⁴ Present address: Nassau County Medical Center, East Meadow, N. Y. 11554.

⁵ Present address: Los Angeles County-University of Southern California Medical Center, Los Angeles, Calif. 90033.

Received 1/20/71. Accepted 2/28/73.

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