title: Phase II study of cisplatin, ifosfamide, and etoposide combination for advanced non-small cell lung cancer: final report.
abstract: Ifosfamide has shown promising single-agent activity in non-small cell lung cancer. We combined ifosfamide (1,800 mg/m2, plus 1,100 mg/m2 of mesna by intravenous continuous infusion daily for 3 days) with cisplatin (20 mg/m2 intravenously for 3 days) and etoposide (80 mg/m2 intravenously for 3 days) and treated 41 patients with recurrent or metastatic non-small cell lung cancer who had received no prior systemic chemotherapy. Fifteen (40.5%) of the 37 evaluable patients had objective responses (one complete and 14 partial). Patients with a good Zubrod performance status (ie, 0 or 1) had a higher response rate than those with poor performance status (ie, 2) (11 of 21 [52.4%] v 4 of 16 [25.0%]), but the difference was not statistically significant (P = .09). Median survival was 28 weeks for all patients and 59+ weeks for responders, with 11 patients still alive after a median follow-up of 59 weeks (range, 51 to 77 weeks). Overall, treatment was well tolerated, with granulocytopenia being the most frequent toxicity. Considering the pooled response rate of 32% with a cisplatin/etoposide regimen and the previous experience from our institution, the results with this three-drug regimen are encouraging, and its further investigation is warranted, particularly for patients who have good performance status and in a neoadjuvant setting.
authors.affiliation: Department of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
authors.forename: M
authors.initials: M
authors.lastname: Shirinian
authors.forename: J S
authors.initials: JS
authors.lastname: Lee
authors.forename: H H
authors.initials: HH
authors.lastname: Dhingra
authors.forename: J
authors.initials: J
authors.lastname: Greenberg
authors.forename: W K
authors.initials: WK
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000556:secondary; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis
chemical_list: D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide