A randomised clinical trial of isosfamide, carboplatin and etoposide with mid-cycle vincristine (ICE-V) versus standard practice chemotherapy in patient with small-cell lung cancer (SCLC) and good performance status

Testing a new combination of chemotherapy drugs to treat lung cancer

What was this study about?

Many people who are diagnosed with small-cell lung cancer die – usually within 2 years of being told they have cancer. Chemotherapy can help to prolong people’s lives. But it can often cause side effects that mean that people may live a little longer, but have a lower quality of life. Doctors in Manchester developed a combination of chemotherapy drugs called ICE-V - isosfamide, carboplatin, etoposide and vincristine. They hoped that this combination of drugs would lead to increased survival. They thought that there might be some reduction in quality of life. But if people lived longer, this reduction might be acceptable.

The LU21 trial aimed to test the ICE-V combination of drugs against the normal treatment for people with small-cell lung cancer.

What difference did this study make?

This trial found that the people treated with ICE-V lived longer than the people who were treated with the normal chemotherapy. There was some increase in the amount of side effects, but not as much as had been expected, and many people felt the increase was acceptable.

One of the drugs in the ICE-V combination was carboplatin. Carboplatin is a platinum drug, and platinum drugs (carboplatin and cisplatin) have been shown in many trials to be the cornerstone of treatment for patients with small-cell lung cancer. In this trial, few of the patients who received the ‘normal’ treatment received platinum. So researchers concluded that the benefit seen with ICE-V was probably as a result of giving carboplatin. A simpler treatment which contained platinum (cisplatin and etoposide) is now widely used rather than the more complex and toxic ICE-V.

Type of study

Randomised trial

Contact details

Who funded the study?

The trial was funded by the Medical Research Council. Some funding was given by the pharmaceutical company ASTA Medica.

When did it take place?

This trial recruited patients between 1996 and 2002. The results of the trial were published in 2005.

Who was included?

402 patients were randomised to receive either ICE-V or the normal chemotherapy treatment.