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Etoposide, Ifosfamide, and Cisplatin in Extensive Small Cell Lung Cancer
Author(s) -
Loehrer Patrick J.,
Rynard Susan,
Ansari Rafat,
Songer Joseph,
Pennington Kenneth,
Einhorn Lawrence
Publication year - 1992
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19920201)69:3<669::aid-cncr2820690312>3.0.co;2-v
Subject(s) - medicine , etoposide , ifosfamide , regimen , surgery , chemotherapy , cisplatin , lung cancer , chemotherapy regimen , urology , gastroenterology
From December 1987 through April 1989, 40 patients with extensive‐stage small cell carcinoma of the lung were enrolled in a Hoosier Oncology Group (HOG) trial using etoposide, ifosfamide, and cisplatin (VIP). Patients with extensive disease were eligible if they had not received prior chemotherapy, had a Karnofsky performance status of 50 or more, and had adequate renal function (creatinine, < 1.5 mg/dl) and bone marrow reserve (granulocyte count, ≥ 2500/μl; platelets, ≥ 125,000/μl). Doses of therapy were: etoposide 75 mg/m 2 /day on days 1 to 5, ifosfamide 1.2 g/m 2 /day on days 1 to 5, and cisplatin 20 mg/m 2 /day on days 1 to 5. The first 11 patients received a 5‐day course; this was repeated every 21 days for four cycles, but therapy was shortened to 4 days when unacceptable toxicity was noticed in these patients. Overall, 14 (37%) had a complete remission (overall response rate, 71.1%) with a median survival of 42 weeks (28 weeks on 5‐day regimen and 45 weeks on 4‐day regimen). There were five early deaths. Although toxic, VIP produces a high complete remission rate in patients with extensive disease and warrants further evaluation. A prospective randomized trial comparing cisplatin and etoposide to the VIP regimen is underway through HOG.