Phase II study of ifosfamide, carboplatin, and etoposide in patients with advanced non-small cell lung cancer

R. K. Hsieh, Alex Y Chang, L. Boros, R. Asbury

Research output: Contribution to journalArticle

Abstract

This study was to define the efficacy of ifosfamide, mesna, carboplatin, and etoposide (ICE) in patients with metastatic non-small cell lung cancer (NSCLC). From September 1990 to October 1991, 33 patients were treated with ifosfamide/mesna 1.25 g/m2/day and etoposide 80 mg/m2/day intravenously from days 1 to 3, and carboplatin 300 mg/m2 on day 1 every 4 weeks. There were 20 male patients and 13 females. The median age was 65 (range: 38-79). Seventeen patients had a performance status (PS) of 0 or 1, and 16 had a PS of 2 or 3. All had measurable diseases. Nine had initial treatment for localized disease with concurrent radiation, 5-fluorouracil, and interferon- α(2b) and four had radiation only. None had received chemotherapy for metastatic disease. There were nine partial responses (PR) (27.3%, 9/33) with a median response duration of 8 months (range: 2-16 months). Five patients had stable diseases (SD), which lasted for 3, 6+, 7+, 10+, or 13.4 months. The median survival was 8 months for PR and SD and 4 months for the entire group. Patients with PS of 2 or 3 were less likely to respond (18.8% vs 35.3%) and had a shorter median survival (2.7 months vs 6 months) than patients with better PS. Dose-limiting toxicity was myelosuppression. Seventeen (51.5%, 17/33) patients developed grade III-IV leukopenia with four septic episodes and three septic deaths. Grade III or IV thrombocytopenia was seen in live patients. Patients with prior radiation were significantly more prone to develop leukopenia (P <.005). Gastrointestinal toxicity was mostly mild. No neurologic or genitourinary toxicity was observed. In conclusion, ICE is active in patients with advanced NSCLC and good PS. Besides myelosuppression, it is well tolerated. Further study is indicated to evaluate if granulocyte-colony stimulating factor can reduce myelosuppression from ICE in good PS patients.

Original languageEnglish (US)
Pages (from-to)509-513
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume17
Issue number6
StatePublished - 1994
Externally publishedYes

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Ifosfamide
Carboplatin
Etoposide
Non-Small Cell Lung Carcinoma
Mesna
Leukopenia
Radiation
Survival
Granulocyte Colony-Stimulating Factor
Fluorouracil
Thrombocytopenia
Interferons
Nervous System

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Phase II study of ifosfamide, carboplatin, and etoposide in patients with advanced non-small cell lung cancer. / Hsieh, R. K.; Chang, Alex Y; Boros, L.; Asbury, R.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 17, No. 6, 1994, p. 509-513.

Research output: Contribution to journalArticle

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abstract = "This study was to define the efficacy of ifosfamide, mesna, carboplatin, and etoposide (ICE) in patients with metastatic non-small cell lung cancer (NSCLC). From September 1990 to October 1991, 33 patients were treated with ifosfamide/mesna 1.25 g/m2/day and etoposide 80 mg/m2/day intravenously from days 1 to 3, and carboplatin 300 mg/m2 on day 1 every 4 weeks. There were 20 male patients and 13 females. The median age was 65 (range: 38-79). Seventeen patients had a performance status (PS) of 0 or 1, and 16 had a PS of 2 or 3. All had measurable diseases. Nine had initial treatment for localized disease with concurrent radiation, 5-fluorouracil, and interferon- α(2b) and four had radiation only. None had received chemotherapy for metastatic disease. There were nine partial responses (PR) (27.3{\%}, 9/33) with a median response duration of 8 months (range: 2-16 months). Five patients had stable diseases (SD), which lasted for 3, 6+, 7+, 10+, or 13.4 months. The median survival was 8 months for PR and SD and 4 months for the entire group. Patients with PS of 2 or 3 were less likely to respond (18.8{\%} vs 35.3{\%}) and had a shorter median survival (2.7 months vs 6 months) than patients with better PS. Dose-limiting toxicity was myelosuppression. Seventeen (51.5{\%}, 17/33) patients developed grade III-IV leukopenia with four septic episodes and three septic deaths. Grade III or IV thrombocytopenia was seen in live patients. Patients with prior radiation were significantly more prone to develop leukopenia (P <.005). Gastrointestinal toxicity was mostly mild. No neurologic or genitourinary toxicity was observed. In conclusion, ICE is active in patients with advanced NSCLC and good PS. Besides myelosuppression, it is well tolerated. Further study is indicated to evaluate if granulocyte-colony stimulating factor can reduce myelosuppression from ICE in good PS patients.",
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