IFOSFAMIDE, CISPLATIN AND ETOPOSIDE (ICE) COMBINED CHEMOTHERAPY WITH RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR SUPPORT IN SMALL-CELL LUNG-CANCER

This study was aimed to evaluate the effect of ifosfamide, cisplatin a nd etoposide (ICE) combined chemotherapy in small cell lung cancer (SC LC), and to test the feasibility of adding recombinant human granulocy te colony-stimulating factor (rhG-CSF) to aggressive chemotherapy. Thi rty consecutive, previously untreated, patients with SCLC (17 with lim ited disease and 13 with extensive disease) entered this study. The IC E regimen consisted of ifosfamide (I) 4 g/m(2) i.v. with same dose mes na i.v. on first day, cisplatin (C) 25 mg/m(2) i.v. on days 1 to 3 and etoposide (E) 100 mg/m(2) i.v. on days 1 to 3. A total of 30 MU rhG-C SF i.v. were given from day 7 to 14 if WBC were lower than 3000x10(6)/ L, neutrophils were lower than 1000x10(6)/L. Overall response (OR) rat e was 93% with a complete response (CR) rate of 23%. Median survival w as 12 months [95% confidence interval (CI): 11-14] and median response duration was 10 months [95% CI: 8-10]. Thirty-seven percent of: patie nts had grade 3 neutropenia, 40% had grade 3 anemia, and 1% had grade 2 thrombocytopenia. Nonhematologic toxicity was mild with nausea and v omiting being the most common. RhG-CSF, which reduced leukopenic nadir s and shortened the neutropenic period, was also well tolerated. This chemotherapy protocol seems to be active, well tolerated and is curren tly being compared with various conventional chemotherapies.