Vincristine or Vmdesine plus BCNU, Adriamycin and Prednisone for Refractory Lymphoma1

SummaryBetween 1977 and 1979 we carried out a Phase II trial of a four-drug combination (vincristine, BCNU, adriamycin, and prednisone [VBAP] ) for patients with refractory lymphoma. VBAP produced a 30 % response rate in 33 patients with diffuse non-Hodgkin's lymphoma (NHL) with a 4-month median duration of response and a 56 % response rate in 16 patients with Hodgkin's disease (HD) with responses lasting a median of 8 months. Toxicity was mild and quite acceptable. In 1979 we also completed a Phase II trial of vindesine in patients with far-advanced refractory lymphoma and observed objective responses in 6 of 11 patients with NHL and in 1 of 2 patients with HD. There was no apparent clinical evidence of cross-resistance between vindesine and prior Vinca alkaloid use. Accordingly, in 1979 we initiated a new Phase II four-drug program substituting vindesine („Eldesine") for vincristine in the VBAP combination. Presently 26 patients have been registered, of whom 23 are evaluable for response. The preliminary results of „EBAP“ are as follows: a 36 % response rate in 11 patients with diffuse NHL and an 89 % response rate in 9 patients with HD including 2 complete remissions. One of 3 patients with nodular lymphoma has also responded. These preliminary results are sufficiently encouraging to warrant continued study of EBAP for refractory lymphoma.