Doublets and Triplets: New Drug Combinations in the Palliative Care of NSCLC

ABSTRACT: Chemotherapy has been shown to prolong survival in patients with stage IV non-small-cell lung cancer (NSCLC). However, traditional cisplatin (Platinol)-containing regimens are associated with significant toxicity. Furthermore, response rates rarely exceed 30%, and median survival times have averaged 25 to 30 weeks. In an effort to improve these results, we have conducted studies integrating new, active single agents into novel combination regimens. In a phase I/II study, the combination of ifosfamide (Ifex) and vinorelbine (Navelbine) was associated with a response rate of 40% and few subjective toxicities. In a phase I study of ifosfamide plus paclitaxel (Taxol), partial responses were observed in 23% of patients, with a median survival of 6 months and a 1-year survival rate of 25%. Another phase I study found a partial response rate of 21% with this combination. Further studies of these “doublet” regimens are in progress. A phase II study is currently evaluating the use of all three drugs (ifosfamide, vinorelbine, and paclitaxel) in one “triplet” combination regimen. Results should be available in the near future. [ONCOLOGY 11(Suppl 12):35-38, 1997]

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