Chemotherapy for advanced head and neck cancer with the combination adriamycin, cyclophosphamide, and cis-diamminedichloroplatinum (II): Preliminary assessment of a one-day vs. three-day drug regimen

Fourteen patients with advanced head and neck carcinomas received a monthly intravenous regimen of Adriamycin, 40 mg/m2, day 1; cyclophosphamide, 400 mg/m2, day 3; and cis-diamminedichloroplatinum, 20 mg/m2/1 hour, days 1-3 (CAP-3). A regression rate of only 7% (0/12 squamous cell carcinomas; 1/2 adenocarcinomas) and a median survival of five months for all patients was accompanied by considerable gastrointestinal toxicity. These results strikingly diverge from a prior study that achieved a 64% (16/25) regression rate using comparable doses of each agent but was administered by rapid infusion on one day each month (CAP-1). Admittedly, the relatively impaired performance scores of the CAP-3 participants may have had some impact on these discouraging results. On the other hand, the maximum therapeutic efficacy of the combination Adriamycin, cyclophosphamide, and cis-platinum may well depend upon subtle interactions of cell cycle kinetics and dosage and schedule of each agent.