Overview of ifosfamide in small cell and non-small cell lung cancer

The alkylating agent ifosfamide, an analogue of cyclophosphamide, has undergone extensive testing in the treatment of bronchogenic carcinoma. Available data indicate that ifosfamide as a single agent can effect a 50% objective response rate in small cell lung cancer (SCLC) and a 25% response rate in non-small cell lung cancer (NSCLC). With mesna uroprotection, the primary dose-limiting toxicity is myelosuppression. In combination with other active agents, ifosfamide has yielded high response rates in both SCLC and NSCLC. Results of recent trials indicate that ifosfamide can be used safely in combination chemotherapy. Determination of the precise role of this agent in overall management of bronchogenic carcinoma requires additional study, however.