Randomised trial comparing sequential methotrexate (or 5-FU), vinblastine and ifosfamide to vincristine, adriamycin and ifosfamide in advanced lung cancer

Summary A randomised trial has compared the sequential administration of ifosfamide (with its urinary antidote mesna) combined with methotrexate (or 5-FU in adenocarcinomas) and vinblastine (protocol I) or combined with adriamycin and vincristine (protocol II) in advanced lung cancer. In 29 evaluable cases the results were not influenced by the protocol nor by the histology of the tumors (oat cell v non-oat cell) or the clinical stage (limited v extensive). An overall response rate of 58.6% was obtained (100% in the oat cell and anaplastic carcinomas, 44% in adenocarcinomas, 50% in squamous cell carcinomas) with a clear prolongation of survival in responding groups, whatever the clinical stage.