Japanese Journal of Clinical Oncology 33:509-513 (2003)
© 2003 Foundation for Promotion of Cancer Research
Vinorelbine, Ifosfamide, and Cisplatin Combination as Salvage Chemotherapy in Advanced Non-Small Cell Lung Cancer
1 Department of Internal Medicine, Kangwon National University Hospital, Kangwon-Do, 2 Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Background: Platinum-based chemotherapy improves survival and quality of life as compared with the best supportive care alone in advanced non-small cell lung cancer. In addition, several recent studies using new drugs such as docetaxel have demonstrated that second-line chemotherapy may be of value.
Methods: We studied the efficacy of combination treatment with vinorelbine, ifosfamide, and cisplatin (NIP) as salvage chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). From March 1998 to December 1999, 44 previously treated patients (etoposide/cisplatin (EP): 36, EP
taxane/cisplatin: 8) were treated with a chemotherapy regimen consisting of vinorelbine (25 mg/m2 i.v. on days 1, 15 and 12.5 mg/m2 i.v. on day 8), ifosfamide (3 g/m2 i.v. on day 1 with mesna) and cisplatin (60 mg/m2 i.v. on day 1). The cycles were repeated every 4 weeks.
Results: All patients were evaluable for response. The median follow-up duration was 19.1 months (range, 4.4–28.3 months). The objective response rate was 27.3% (95% CI, 14.1%–40.5%) with one complete response and 11 partial responses. The median response duration was 4.1 months (range, 1.5–13 months). The median time to progression was 2.9 months (range, 0.7–15.3 months). The main toxicity was hematologic in the 138 evaluable courses, granulocytopenia (
grade III) and anemia (grade III) were observed in 3.6% and 0.7% of the patients, respectively. Non-hematologic toxicities were minor and easily controlled. Four episodes of febrile neutropenia were reported. There were no treatment-related deaths.
Conclusion: In this study, the combination of vinorelbine, ifosfamide and cisplatin showed a significant efficacy with acceptable toxicities as salvage chemotherapy in previously treated advanced NSCLC patients.
+ For reprints and all correspondence: Keunchil Park, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135–710, Korea. Tel: +82-02–3410-3459, Fax: +82-02–3410-3849, E-mail: kpark{at}smc.samsung.co.kr
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