Ifosfamide in the treatment of small cell lung cancer.

Ifosfamide as a single agent has produced overall response rates greater than 5O% in the treatment of small cell lung cancer (SCLC). Etoposide/ifosfamide/cisplatin (VIP) has produced overall response rates of 74% to 100% with complete response rates of 27% to 64% in SCLC patients. In a Hoosier Oncology Group randomized study involving extensive-disease SCLC patients, VIP was superior to etoposide/cisplatin with regard to median time to progression (6.6 v 5.8 months), median survival times (9.1 v 7.3 months), and 2- and 3-year survival rates (13% v 5% and 5% v 0%, respectively). In limited-disease SCLC, ifosfamide/carboplatin/etoposide (ICE) achieved overall response rates of 76% to 94%, median durations of survival ranging from 14 to 19 months, and 2-year survival rates of 24% to 37%; in extensive disease, overall response rates ranged from 72% to 100%, median durations of survival ranged from 9 to 14 months, and 2-year survival rates ranged from 14% to 22%. The use of high-dose ICE plus epirubicin and peripheral blood stem cell support appears promising in the treatment of limited-disease SCLC.