MODIFIED ICE STUDY - A PHASE-II STUDY OF AN INTENSIVE, MODIFIED ICE REGIMEN (IFOSFAMIDE, CARBOPLATIN AND ETOPOSIDE) IN PATIENTS WITH BETTERPROGNOSIS, SMALL-CELL LUNG-CANCER

A total of 30 with good prognosis small cell lung cancer were treated with a modified 'ICE' (ifosfamide, carboplatin and etoposide) chemothe rapy regimen in an attempt to achieve a high response rate with less t oxicity than is seen with the full 'ICE' regimen. This was given every 4 weeks for a maximum of six cycles. In total 25 patients (83%, 95% C I (70-97%)) experienced a partial or complete response at some stage o f their treatment. Of these patients, 12 (40%, 95% CI (22-58%)) showed a complete response. A total of 19 patients (63%) had to have their d ose reduced and/or delayed at some point due to toxicity. Nadir blood counts showed that 19 patients (63%, 95% CI (46-81%)) had WHO grade 3 or 4 thrombocytopenia, and 24 (86%, 95% CI (73-99%)) had grade 3 or 4 neutropenia. A total of 17 patients (53%) completed six cycles of chem otherapy. In total 3 patients died during treatment-all due to treatme nt-related complications. Median survival was 12.6 months (95% CI(11.6 , 14.7 months)). Nausea, vomiting, dysphagia, activity, mood and overa ll condition, as recorded using daily diary cards, were worse at the b eginning of each chemotherapy cycle. Both response rates and survival were clinically acceptable. However, neutropenia and thrombocytopenia, although reduced from rates reported with the full ICE regimen, were still high. A prospective randomised controlled trial is now needed to assess this regimen in more detail. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.