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993
CORRESPONDENCE
Teniposide (VM-26) as a Single Drug
Treatment for Patients with Extensive Small
Cell Lung Carcinoma: A Phase II Study of the
Southwest Oncology Group
G
rozea et al. reported on a Phase II study of teniposide (VM26)
administered to previously untreated patients with extensive small
cell carcinoma of the lung.1 Of 41 eligible patients, there were 10
confirmed responses, for a response rate of 24% and a 95% confidence
interval of 12% to as high as 40%! The authors’ conclusion, as stated
in the abstract, was that teniposide (VM26) has ‘‘modest activity’’ in
extensive small cell lung carcinoma. In the precis in the table of
contents, the authors state that teniposide has ‘‘limited activity’’ in
small cell lung carcinoma.
I would submit that the connotations of these two terms are
quite different. Both terms are qualitative and obviously imprecise.
‘‘Limited activity’’ would probably not suffice for practicing oncologists to offer it as second- or third-line therapy, but ‘‘modest activity’’
just might provide a modicum of enthusiasm for using the drug.
I would plead the case for a more precise assessment and evaluation
of response rates. If these qualitative terms are to be used, there needs
to be some kind of scientific criteria to define them, although I would
opt for banishment of both terms because they are nothing more than
opinions that should be within the purview of the reader to judge.
One final thought on the subject is that if one simply looks at the
reported response rate of 24%, wouldn’t we view it very differently,
depending on the tumor being treated? For example, a 24% response
rate for renal cell carcinoma would be smashing, if not laudable;
however, a 24% response rate for breast carcinoma would be noteworthy but not necessarily smashing.
REFERENCE
1.
Grozea PN, Crowley JJ, Canfield VA, Kingsbury L, Ross SW, Beltran GS, et al.
Teniposide (VM-26) as a single drug treatment for patients with extensive
small cell lung carcinoma. Cancer 1997;80:1029–33.
Jacob J. Lokich, M.D.
The Cancer Center of Boston
Boston, Massachusetts
Malignant Fibrous Histiocytoma of Bone: A
Clinicopathologic Study of 81 Patients
M
alignant fibrous histiocytoma (MFH) of bone represents approximately 5% of all malignant bone tumors. Therefore, institutional
experience in the treatment of this malignancy is limited. The series
of MFH of bone described by Nishida et al.1 is an extremely large series.
q 1998 American Cancer Society
/ 7bb8$$1636
02-09-98 15:10:33
canal
W: Cancer
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