A controlled study of combined 1,3-bis-(2-chloroethyl)-1-nitrosourea and 5-fluorouracil therapy for advanced gastric and pancreatic cancer

Treatment with the combination of 1, 3-bis-(2-chloroethyl)-1-nitrosourea (BCNU) and 5-fluorouracil (5-FU) was compared to therapy with each drug used alone in a prospective randomized study of 167 patients with advanced adenocarcinoma of the stomach and pancreas. At dosages producing comparable degrees of hematologic toxicity, the combination was associated with the highest rate of objective response, 41.3% in carcinoma of the stomach and 33.3% in carcinoma of the pancreas. The corresponding rates of objective response with 5-FU alone were 28.6% and 16.1%; and with BCNU alone 17.4% and 0%. In pancreatic carcinoma there was no discernible difference in survival among patients in each treatment arm. In gastric carcinoma, however, both 5-FU and die combination produced an increase in survival when compared to BCNU alone, and the combination of 5-FU and BCNU produced an increase in long-term survival compared to 5-FU alone.