Comparison of Vinorelbine, Ifosfamide and Cisplatin (NIP) and Etoposide and Cisplatin (EP) for Treatment of Advanced Combined Small Cell Lung Cancer (cSCLC) Patients: A Retrospective Study

  • Luo, Jie (Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine) ;
  • Wu, Feng-Ying (Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine) ;
  • Li, Ai-Wu (Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine) ;
  • Zheng, Di (Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine) ;
  • Liu, Jin-Ming (Department of Respiratory, Shanghai Pulmonary Hospital, Tongji University School of Medicine)
  • Published : 2012.09.30


Objective: To compare efficacy and safety profile of vinorelbine, ifosfamide and cisplatin (NIP) with etoposide and cisplatin (EP) in the treatment of advanced combined small cell lung cancer (c-SCLC). Methods: From January 2006 to December 2010, 176 patients with advanced c-SCLC were enrolled. The primary endpoint was overall survival (OS) and the secondary endpoints were progression free survival (PFS), response rate (RR) and toxicity. Results: Overall RR was 30.0% in the NIP and 38.5% in the EP group; there was no significant difference (P=0.236). The PFS in the EP group was little longer than that of NIP group, with 6.5 months for EP and 6.0 months for NIP group, but the difference was statistically non-significant (P=0.163). The median OS and one year survival rates were 10.4 months and 36.3% for NIP group, and 10.8 months and 49.0% for EP respectively, EP showing a survival benefit, although this was not statistically significant. Both groups well tolerated the adverse effects. The incidence of grade I-II leucopenia and alopecia in the NIP group was significantly higher than that of EP group (32.5% vs. 10.4% (P<0.001, 35.0% vs. 12.5%, P<0.001). Conclusion: the ORR, PFS and OS in NIP were slightly inferior to traditional regimen EP. The toxicity of NIP can be considered tolerable. The usage of three drugs combination in the treatment of mixed SCLC remains uncertain. Nevertheless, the results need to be further confirmed by large, prospective clinical trials.


  1. Adelstein DJ, Tomashefski JF, Jr, Snow NJ, et al (1986). Mixed small cell and non-small cell lung cancer. Chest, 89, 699- 704.
  2. Baldini E, Tibaldi C, Chella A, et al (1996). Phase II study of Vinorelbine/ ifosfamide/Cisplatin for the treatment of advanced non-small cell lung cancer. Ann Oncol, 7, 747-9.
  3. Barone C, Corsi DC, Pozzo C, et al (2000). Vinorelbine and alternating Cisplatin and ifosfamide in the treatment of nonsmall cell lung cancer. Oncology, 58, 25-30.
  4. Gottfried M, Ramlau R, Krzakowski M, et al (2008). Cisplatinbased three drugs combination (NIP) as induction and adjuvant treatment in locally advanced non-small cell lung cancer: final results. J Thorac Oncol, 3, 152-7.
  5. Mangum MD, Greco FA, Hainsworth JD, et al (1989). Combined small-cell and non-small-cell lung cancer. J Clin Oncol, 7, 607-12.
  6. Montalar J, Morales S, Maestu I, et al (2001). Vinorelbine, ifosfamide and Cisplatin as first-line treatment in patients with inoperable non-small cell lung cancer. Lung Cancer, 34, 305-11.
  7. Nicholson SA, Beasley MB, Brambilla E, et al (2002). Small cell lung carcinoma (SCLC): a clinicopathologic study of 100 cases with surgical specimens. Am J Surg Pathol, 26, 1184-97.
  8. Radice PA, Matthews MJ, Ihde DC, et al (1982). The clinical behavior of "mixed" small cell/large cell bronchogenic carcinoma compared to "pure" small cell subtypes. Cancer, 50, 2894-902.<2894::AID-CNCR2820501232>3.0.CO;2-G
  9. Rey F, Astoul P, Marqueste L, et al (1998). Cisplatin, ifosfamide and Vinorelbine combination chemotherapy in stage III-IV non-small cell lung cancer-a phase II study. Am J Oncol, 21, 518-22.
  10. Souquet PJ, Fournel P, Bohas CH, et al (1996). Cisplatin and ifosfamide with various doses of Vinorelbine (Navelbine(R)) in advanced non-small cell lung cancer. Semin Oncol, 23, 8-10.
  11. Souquet PJ, Tan EH, Rodrigues Pereira J, et al (2002). GLOB-1: a prospective randomised clinical phase III trial comparing Vinorelbine - Cisplatin with Vinorelbine - Ifosfamide - Cisplatin in metastatic non-small-cell lung cancer patients. Ann Oncol, 13, 1853-61.
  12. Tan EH, Ang PT, Wee J, et al (1999). Vinorelbine, Ifosfamide and Cisplatin in advanced non-small cell lung cancer. Acta Oncol, 38, 619-22.
  13. Travis WD, Brambilla E, Muller-Hermelink HK, Harris CC (2004). Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. World Health Organization Classification of Tumours. IARC Press, France.
  14. Song SY, Kim WS, Kim K, et al (2003). Vinorelbine, Ifosfamide, ND Cisplatin Combination as Salvage Chemotherapy in advanced Non-small cell lung cancer. Jpn J Clin Oncol, 33, 509-13.

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