Vinorelbine and alternating cisplatin and ifosfamide in the treatment of non-small cell lung cancer

In order to explore the activity of a combination of vinorelbine (VNL) and alternating cisplatin (CDDP) and ifosfamide (IFX) in non-small cell lung ca ncer (NSCLC), a phase II study was performed. Seventy chemoradiotherapy nai ve patients with NSCLC, stage IIIA, IIIB and IV disease, PS (ECOG) less tha n or equal to 2, were treated with CDDP 40 mg/m(2) on days 1, 2, 3, IFX 1,8 00 mg/m(2) on days 22, 23, 24 and VNL 30 mg/m(2) on days 1, 8, 22, 29 every 6 weeks up to 6 courses. In the 67 evaluable patients, an objective respon se rate was observed in 47.8 +/- 12% (95% CI) with complete responses in 6% ; responses occurred more frequently in patients with locally advanced dise ase (stage IIIA/IIIB) and/or performance status 0. The median duration of s urvival was 12 months: 19.9 months in stage III patients who received an in tegrated treatment and 10 months in metastatic disease. The median time to treatment failure was 10.5 months. Toxicity was mainly hematological, even though it was not dose-limiting and easily manageable. This combination see ms to be active, and the good safety profile is probably the result of the use of an alternating schedule of CDDP and IFX. Median overall survival was also encouraging in stage IV disease. The prolongation of survival obtaine d when surgery and/or radiotherapy is applicable needs confirmation through a larger study. Copyright (C) 2000 S. Karger AG. Basel.