title: Pei regimen: a therapeutic option in small cell lung cancer? A retrospective monoinstitutional analysis of 46 consecutive cases.
abstract: OBJECTIVE
  Combination chemotherapy is very active in small cell lung cancer (SCLC), although no improvement in overall survival (OS) has been done in the last 25 years, with Cisplatin-Etoposide (PE) still considered the world-wide standard, with an average median survival of about 7-8 months in patients with extended disease (ED). In 1995, a randomized trial of the Hoosier Group in 171 ED patients showed a significant advantage in overall survival in patients treated with PEI (Cisplatin, Etoposide and Ifosfamide), compared to PE. Despite that, PEI regimen has not become a commonly used regimen in SCLC.
  
  
  METHODS
  Here we present a retrospective analysis of 46 consecutive patients (30 males and 16 females) with SCLC that were treated at our Institution with PEI regimen: Cisplatin 20 mg/m2, Etoposide 75 mg/m2 and Ifosfamide 1200 mg/m2, day 1 to 4, every 3 weeks. Patients received a total of 219 cycles of chemotherapy, with a mean of 4,7 cycles per patient. Median age was 63 (range 59-70); performance status (PS) was 0 in 29 patients (63%), 1 in 13 patients (28%) and 2 in 4 patients (9%).
  
  
  RESULTS
  In 19 limited disease (LD) patients partial response (PR) rate was 74%, and complete response (CR) was 16%. In 27 ED patients we observed 63% of PR and 26% of CR. Median time to progression (TTP) was 15.2 months in LD and 7.1 months in ED with median overall survival (OS) of 28.2 and 11.8 months, respectively. Toxicity was manageable, with a high dose intensity.
  
  
  CONCLUSIONS
  PEI regimen, in our opinion, may be a possible therapeutic option, with high activity and an acceptable toxicity profile.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT02324296 .
  Institutional review board of Reggio Emilia, Azienda Ospedaliera S.Maria Nuova/IRCCS.
authors.affiliation: Department of Oncology and Advanced Technologies, Oncology Unit, Azienda Ospedaliera S.Maria Nuova/IRCCS of Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, (Italy). boni.corrado@asmn.re.it.
authors.forename: Corrado
authors.initials: C
authors.lastname: Boni
authors.affiliation: Department of Oncology and Advanced Technologies, Oncology Unit, Azienda Ospedaliera S.Maria Nuova/IRCCS of Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, (Italy). pagano.maria@asmn.re.it.
authors.forename: Maria
authors.initials: M
authors.lastname: Pagano
authors.affiliation: Department of Oncology and Advanced Technologies, Oncology Unit, Azienda Ospedaliera S.Maria Nuova/IRCCS of Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, (Italy). baldi.licia@asmn.re.it.
authors.forename: Licia
authors.initials: L
authors.lastname: Baldi
authors.affiliation: Department of Oncology and Advanced Technologies, Oncology Unit, Azienda Ospedaliera S.Maria Nuova/IRCCS of Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, (Italy). gnoni.roberta@asmn.re.it.
authors.forename: Roberta
authors.initials: R
authors.lastname: Gnoni
authors.affiliation: Department Infrastructure Research and Statistics, Azienda Ospedaliera S.Maria Nuova/IRCCS of Reggio Emilia, Reggio Emilia, (Italy). luca.braglia@asmn.re.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Braglia
authors.affiliation: Department Infrastructure Research and Statistics, Azienda Ospedaliera S.Maria Nuova/IRCCS of Reggio Emilia, Reggio Emilia, (Italy). luisa.savoldi@asmn.re.it.
authors.forename: Luisa
authors.initials: L
authors.lastname: Savoldi
authors.affiliation: Department of Oncology and Advanced Technologies, Oncology Unit, Azienda Ospedaliera S.Maria Nuova/IRCCS of Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, (Italy). francesca.zanelli@asmn.re.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Zanelli
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D018450:Disease Progression; 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; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide