Ifosfamide, carboplatin, and etoposide with midcycle vincristine versus standard chemotherapy in patients with small-cell lung cancer and good performance status: clinical and quality-of-life results of the British Medical Research Council multicenter randomized LU21 trial.

2.50
Hdl Handle:
http://hdl.handle.net/10541/76794
Title:
Ifosfamide, carboplatin, and etoposide with midcycle vincristine versus standard chemotherapy in patients with small-cell lung cancer and good performance status: clinical and quality-of-life results of the British Medical Research Council multicenter randomized LU21 trial.
Authors:
Thatcher, Nick; Qian, Wendi; Clark, Peter I; Hopwood, Penelope; Sambrook, Robert J; Owens, Robert; Stephens, Richard J; Girling, David J
Abstract:
PURPOSE: Ifosfamide, carboplatin, etoposide, and vincristine, alone and in combination, are highly active against small-cell lung cancer (SCLC). This trial was designed to investigate whether survival could be improved by a regimen of all four drugs (ICE-V) compared with standard chemotherapy in patients with SCLC and good performance status, and to assess the patients' quality of life (QL). PATIENTS AND METHODS: Patients were randomly assigned to receive six cycles of either ICE-V at 4-week intervals without dose reduction or standard chemotherapy administered according to local practice. The recommended standard control regimens were cyclophosphamide, doxorubicin, and etoposide; and cisplatin and etoposide. RESULTS: A total of 402 patients were randomly assigned, and 350 (87%) patients have died. Overall survival was longer in the ICE-V group (hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P = .0049), median survival was 15.6 months in the ICE-V group and 11.6 months in the control group, and 2-year survival rates were 20% and 11%, respectively. There was no evidence that the relative survival benefit for ICE-V was less in extensive-stage than in limited-stage patients. An increased rate of septicemia was reported in the ICE-V group (15% v 7% in the control group), but this did not result in an increase in reported treatment-related deaths (four patients [2%] in both groups). The findings on QL were broadly similar in both groups, with some benefit in favor of ICE-V. CONCLUSION: Compared with standard chemotherapy, the ICE-V regimen improves overall survival without QL penalties, despite an increased but manageable level of toxicity.
Affiliation:
Medical Research Council Clinical Trials Unit, London NW1 2DA, United Kingdom.
Citation:
Ifosfamide, carboplatin, and etoposide with midcycle vincristine versus standard chemotherapy in patients with small-cell lung cancer and good performance status: clinical and quality-of-life results of the British Medical Research Council multicenter randomized LU21 trial. 2005, 23 (33):8371-9 J. Clin. Oncol.
Journal:
Journal of Clinical Oncology
Issue Date:
20-Nov-2005
URI:
http://hdl.handle.net/10541/76794
DOI:
10.1200/JCO.2004.00.9969
PubMed ID:
16293867
Type:
Article
Language:
en
ISSN:
0732-183X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorThatcher, Nick-
dc.contributor.authorQian, Wendi-
dc.contributor.authorClark, Peter I-
dc.contributor.authorHopwood, Penelope-
dc.contributor.authorSambrook, Robert J-
dc.contributor.authorOwens, Robert-
dc.contributor.authorStephens, Richard J-
dc.contributor.authorGirling, David J-
dc.date.accessioned2009-08-10T09:15:02Z-
dc.date.available2009-08-10T09:15:02Z-
dc.date.issued2005-11-20-
dc.identifier.citationIfosfamide, carboplatin, and etoposide with midcycle vincristine versus standard chemotherapy in patients with small-cell lung cancer and good performance status: clinical and quality-of-life results of the British Medical Research Council multicenter randomized LU21 trial. 2005, 23 (33):8371-9 J. Clin. Oncol.en
dc.identifier.issn0732-183X-
dc.identifier.pmid16293867-
dc.identifier.doi10.1200/JCO.2004.00.9969-
dc.identifier.urihttp://hdl.handle.net/10541/76794-
dc.description.abstractPURPOSE: Ifosfamide, carboplatin, etoposide, and vincristine, alone and in combination, are highly active against small-cell lung cancer (SCLC). This trial was designed to investigate whether survival could be improved by a regimen of all four drugs (ICE-V) compared with standard chemotherapy in patients with SCLC and good performance status, and to assess the patients' quality of life (QL). PATIENTS AND METHODS: Patients were randomly assigned to receive six cycles of either ICE-V at 4-week intervals without dose reduction or standard chemotherapy administered according to local practice. The recommended standard control regimens were cyclophosphamide, doxorubicin, and etoposide; and cisplatin and etoposide. RESULTS: A total of 402 patients were randomly assigned, and 350 (87%) patients have died. Overall survival was longer in the ICE-V group (hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P = .0049), median survival was 15.6 months in the ICE-V group and 11.6 months in the control group, and 2-year survival rates were 20% and 11%, respectively. There was no evidence that the relative survival benefit for ICE-V was less in extensive-stage than in limited-stage patients. An increased rate of septicemia was reported in the ICE-V group (15% v 7% in the control group), but this did not result in an increase in reported treatment-related deaths (four patients [2%] in both groups). The findings on QL were broadly similar in both groups, with some benefit in favor of ICE-V. CONCLUSION: Compared with standard chemotherapy, the ICE-V regimen improves overall survival without QL penalties, despite an increased but manageable level of toxicity.en
dc.language.isoenen
dc.subjectLung Canceren
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshCarboplatin-
dc.subject.meshCarcinoma, Small Cell-
dc.subject.meshEtoposide-
dc.subject.meshFemale-
dc.subject.meshGreat Britain-
dc.subject.meshHumans-
dc.subject.meshIfosfamide-
dc.subject.meshLung Neoplasms-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshProspective Studies-
dc.subject.meshQuality of Life-
dc.subject.meshStatistics, Nonparametric-
dc.subject.meshSurvival Analysis-
dc.subject.meshVincristine-
dc.titleIfosfamide, carboplatin, and etoposide with midcycle vincristine versus standard chemotherapy in patients with small-cell lung cancer and good performance status: clinical and quality-of-life results of the British Medical Research Council multicenter randomized LU21 trial.en
dc.typeArticleen
dc.contributor.departmentMedical Research Council Clinical Trials Unit, London NW1 2DA, United Kingdom.en
dc.identifier.journalJournal of Clinical Oncologyen

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