EFFICACY AND TOXICITY OF MITOMYCIN, IFOSFAMIDE, AND CISPLATIN (MIP) IN PATIENTS WITH INOPERABLE NON-SMALL-CELL LUNG-CANCER

Seventy-two patients with advanced stage IIIB (42%) or stage IV (58%) non-small cell lung cancer (median age 57 years, Karnofsky PS 60-100) were treated with mitomycin C (6 mg/m(2), day 1), ifosfamide (1500 mg/ m(2), days 1-3), and cisplatin (30 mg/m(2), days 1-3) every 4 weeks. T he objective response rate was 37% in the overall population; 50% in s tage IIIB patients and 29% in stage IV patients. Twenty four patients achieved partial response (33%) and three patients achieved complete r esponse. Despite this relatively high objective response rate, the ove rall median survival time was 32 weeks. The median survival was signif icantly better in stage IIIB patients (55 weeks) than in stage IV pati ents (25 weeks) (P = 0.003). MIP regimen was permanently suspended in 14 patients because of toxic events. Seventeen patients developed grad e III or IV febrile neutropenia and two patients died from sepsis. Two patients experienced acute mitomycin peumonitis. Despite increased do ses of cisplatin and ifosfamide, compared with the original descriptio n for MIC chemotherapy, with probably higher toxicity, no apparent inc reased response rate or median survival was observed in this study. Th e MIP regimen could be tested in a randomized trial in comparison with other administration plans in a comparable population.