Combination chemotherapy in gastrointestinal cancer.

In a prospective, comparative evaluation of therapy in advanced gastrointestinal carcinoma with 5-fluorouracil, mitomycin C, and 1,3-bis-(2-chlorethyl)-l-nitrosourea used alone, in double combination, and in triple combination, 215 adults with proved gastrointestinal adenocarcinoma were randomly assigned to one of seven possible treatment programs. Dosages and schedules were determined from the results of a pilot program to allow comparable toxicity when administered over a comparable time between the programs. Objective evaluation of the overall results at 8 weeks indicates that the effectiveness of the drug combinations did not exceed that of the component drugs used alone. Combined 5-fluorouracil and 1,3-bis-(2-chlorethyl)-l-nitrosourea therapy might be preferentially effective for gastric and pancreatic carcinoma, but further study will be required for more definitive evaluation of this possibility.