A relatively new drug that combines uracil and tegafur, often referred to as UFT, may offer the effectiveness of the commonly used intravenous chemotherapy regimens, with the convenience of administration by mouth for persons with non-small cell lung cancer. Japanese researchers found a survival rate with the chemotherapy combination cisplatin plus UFT that are similar to that of other cisplatin chemotherapy combinations.

Non-small cell lung cancer (NSCLC) is a term used to describe at least 3 types of lung cancer—epidermoid or squamous carcinoma, adenocarcinoma, and large cell carcinoma. NSCLC may be treated with surgery, radiation therapy, and/or chemotherapy. When chemotherapy is needed, a therapy containing platinum (cisplatin or carboplatin) is usually used to increase survival time and relieve symptoms. The most commonly used chemotherapy regimen for NSCLC is cisplatin plus intravenous fluorouracil. However, this treatment often requires the fluorouracil to be administered by continuous intravenous infusion using a catheter and portable pump. Because of the inconvenience of this type of drug administration, alternative methods of delivery are being investigated.

UFT is a drug that can be taken by mouth and is absorbed well in the small intestine. Once ingested, the tegafur in the UFT pill is converted into fluorouracil. The use of UFT taken by mouth may produce blood levels of fluorouracil that are similar to those achieved with continuous infusion of fluorouracil, making UFT a potentially effective and more convenient treatment option for persons with NSCLC.

Researchers in Japan treated 108 persons with stage IIIB locally advanced NSCLC (the cancer had spread in the area of the lung) and metastatic NSCLC (the cancer had spread to other parts of the body) with UFT by mouth and intravenous cisplatin every 2 weeks. The overall response rate was 29%, with 1 person having a complete response. The average time to progression (or advancement) of cancer was 28 weeks. The average survival time was 40 weeks, and the 1-year survival rate was 39%. One patient died from treatment-related problems.

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These findings suggest that cisplatin plus UFT was moderately effective against NSCLC, with the 1-year survival rate being similar to that achieved with other cisplatin chemotherapy combinations. The researchers indicated that studies comparing the effectiveness of UFT plus cisplatin to other cisplatin combination treatments are needed. (Cancer, Vol 88, No 2, pp 318-323, 2000)

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