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Wolff AC , Ettinger DS , Neuberg D , Comis RL , Ruckdeschel JC , Bonomi PD , Johnson DH
Phase-Ii Study of Ifosfamide, Carboplatin, and Oral Etoposide Chemotherapy for Extensive-Disease Small-Cell Lung-Cancer - an Eastern-Cooperative-Oncology-Group Pilot-Study
Journal of Clinical Oncology. 1995 Jul;13(7) :1615-1622
PMID: ISI:A1995RG15700013   
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Purpose: A phase II study of ifosfamide, carboplatin, and prolonged oral administration of etoposide (ICE) in patients with untreated extensive-disease (ED) small-cell lung cancer (SCLC) was conducted to assess toxicities, response, and median survival. Patients and Methods: Between July 1990 and August 1992, 35 patients were treated. ICE doses were ifosfamide 5 g/m(2) by 24-hour continuous intravenous (CIV) infusion with mesna on day 1, carboplatin 300 mg/m(2) intravenously (IV) on day 1, and etoposide 50 mg/m(2) orally on days 1 to 21 every 4 weeks for up to six to eight cycles (schedule I). Because of severe hematologic toxicity in the first 18 patients, the last 17 patients received ifosfamide 3.75 mg/m(2) IV on day 1, carboplatin 300 mg/m(2) IV on day 1, and etoposide 50 mg orally on days 1 to 14 (schedule II). Results: Nine of 18 patients (50%) on schedule I held 13 episodes of severe hematologic toxicity (one death), and only two (11%) received full doses on cycle 2. However, with schedule II, only four of 17 patients (24%) developed severe hematologic toxicity, and eight (47%) received full doses on cycle 2. Objective responses were observed in 29 of 35 patients (83%) (schedule I, 16 of 18 patients [89%]; schedule II, 13 of 17 patients [76%]), There were eight (23%) complete responses (CRs) and 21 (60%) partial responses (PRs). The median survival duration was 8.3 months, and 1- and 2-year survival rates were 37% and 14%, respectively. Conclusion: ICE with oral etoposide has comparable activity with other regimens in ED SCLC, However, the 2-year survival rate may be higher and ICE with the lower doses of schedule II could be given safely with acceptable toxicity. Further studies of ICE compared with standard two- drug regimens are warranted
Times Cited: 19 Article RG157 J CLIN ONCOL