A BETTER THERAPEUTIC PROFILE FOR THE COMBINATION OF MITOMYCIN-C, IFOSFAMIDE AND CISPLATIN (MIC) IN ADVANCED NON-SMALL-CELL LUNG-CANCER - A USEFUL DOSE-SCHEDULE MODIFICATION

Background. In our previous experience with chemotherapy for non-small -cell lung cancer (NSCLC) the combination of mitomycin, ifosfamide and cisplatin (MIG) showed the highest activity in a three-arm randomized trial; the MIC regimen also yielded the most toxic effects, with 8% W HO grade 2-4 nephrotoxicity, 21% grade 3-4 leukopenia and 10% grade 3- 4 thrombocytopenia. In that study cisplatin (120 mg/m(2)) was delivere d on day 1 and ifosfamide and mitomycin on day 2. In an effort to redu ce MIC toxicity a modified regimen was tested in a phase II trial: cis platin 100 mg/m(2) was given on day 2 and ifosfamide day I with mitomy cin. Patients and methods: From November 1993 to December 1995, 70 adv anced NSCLC patients entered the trial. Results: Twenty-nine of 70 pat ients achieved major response (41%) with 6 complete (9%) and 23 partia l remissions (33%). We recorded 4% of WHO grade 3-4 anemia, and 2% of leukopenia and thrombocytopenia. Conclusion: We confirmed the activity of the MIC regimen in NSCLC, and the modified schedule seems to subst antially improve the safety of the combination.