Combination chemotherapy versus single agents followed by combination chemotherapy in stage IV non-small-cell lung cancer: a study of the Eastern Cooperative Oncology

During the last decade, the Eastern Cooperative Oncol-ogy Group (ECOG) has studied a series of combination chemotherapy regimens in metastatic (stage IV) non-small-cell lung cancer (NSCLC). In January 1984, the ECOG activated a randomized study, EST 1583, which concluded the evaluation of combination regimens in phase III trials and initiated the evaluation of single agents exclusively in previously untreated patients. The treatment regimens in EST 1583 consisted of: (1) mitomycin, vinblastine, and cisplatin (MVP); (2) vinblas-tine and cisplatin (VP); (3) MVP alternating with the regimen cyclophosphamide, doxorubicin, methotrex-ate, and procarbazine (CAMP); (4) carboplatin fol-lowed by the MVP regimen at the time of progression; and (5) iproplatin followed by MVP at the time o