Enhancement of the Clinical Activity of Melphalan by the Hypoxic Cell Sensitizer Misonidazole

C. Norman Coleman, Robert W. Carlson, Joanne Halsey, Branimir I. Sikic, Charlotte Jacobs

Research output: Contribution to journalArticlepeer-review


One hundred patients with non-small cell lung cancer were entered by members of the Northern California Oncology Group into a randomized Phase II trial of i.v. melphalan versus i.v. melphalan with concomitant oral misonidazole. The patients had not received prior chemotherapy. Eighty-five patients were evaluable for assessment of response and 89 were evaluable for toxicity analysis. The melphalan/misonidazole group had a superior response rate (two complete and four partial responses among 42 patients or 14%) compared to the melphalan group in which there were no responses among 43 patients (p = 0.024, two-sided Fisher exact test). Since hematological toxicity was equivalent in the two groups, there was an improvement in therapeutic index. Data from 12 patients undergoing pharmacological studies demonstrated that the plasma concentration of melphalan was 25% higher in the misonidazole group, a difference that is not statistically significant. Although the mechanism of interaction has not been fully established, this randomized trial demonstrates that a chemosensitizer can enhance the clinical antitumor activity of an alkylating agent and suggests that chemosensitizers in combination with alkylating agents should be investigated in further clinical trials.

Original languageEnglish (US)
Pages (from-to)3528-3532
Number of pages5
JournalCancer Research
Issue number12
StatePublished - 1988
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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