COMBINATION CHEMOTHERAPY WITH VINDESINE-IFOSFAMIDE-CISPLATIN (VIP) INLOCALLY ADVANCED UNRESECTABLE STAGE-III AND IN STAGE-IV NON-SMALL-CELL LUNG-CANCER - A PHASE-II TRIAL

The efficacy and toxicity of a regimen adding ifosfamide to the more c lassical cisplatin-vindesine combination was studied in patients with advanced non-small cell lung cancer. Sixty-four good performance patie nts with inoperable stage III or stage IV were treated with VIP: vinde sine 3 mg/m(2) days 1 and 8, ifosfamide 1200 mg/m(2) and platinum 30 m g/m(2) days 1, 2 and 3, repeated every 4 weeks, up to a maximum of six cycles. Response rate, clinical data and radiological tests were rigo urously reviewed by a panel. Overall response rate was 39% (95% confid ence interval, 27%-51%) with three patients achieving a complete respo nse; response rate in stage III was 48%. Median survival was 9 months. Toxicity consisted mainly of bone marrow toxicity and nausea/vomiting , but was manageable. There was no renal toxicity greater than grade 2 , four severe infections, but no treatment-related deaths. Conclusion: VIP as mentioned above is very active in good performance patients wi th advanced non-small cell lung cancer. Its activity, together with it s manageable toxicity - without severe renal or pulmonary toxicity - m akes it an attractive candidate for induction chemotherapy.