Front-line paclitaxel/cisplatin-based chemotherapy in brain metastases from non-small-cell lung cancer.

Abstract

OBJECTIVE:

Paclitaxel-cisplatin is considered to be a standard therapy for metastatic non-small-cell lung cancer (NSCLC). The aim of this study was to evaluate the activity and toxicity of this combination with vinorelbine or gemcitabine as front-line therapy in brain metastases from NSCLC.

METHODS:

Twenty-six chemotherapy-naive patients with an ECOG performance status of 0-2 were treated with paclitaxel (135 mg/m(2)) on day 1, cisplatin (120 mg/m(2)) on day 1, and either vinorelbine (30 mg/m(2)) on days 1 and 15 or gemcitabine (800 mg/m(2)) on days 1 and 8. Whole-brain irradiation was offered early in case of progression and later as consolidation treatment.

RESULTS:

All patients were evaluated for toxicity and 25 for response. An intracranial response rate was observed in 38% of the patients (95% CI: 22-59%). WHO grade 3-4 neutropenia and thrombocytopenia occurred in 31 and 4% of the patients, respectively. There was one treatment-related death. Non-hematological toxicities were mild. After a median follow-up of 46 months, the median overall survival for all patients was 21.4 weeks and the median time to progression was 12.8 weeks.

CONCLUSIONS:

Paclitaxel and cisplatin combined with vinorelbine or gemcitabine as front-line therapy in brain metastases seem to achieve responses similar to those for extracranial disease, suggesting a meaningful role in this setting.

• Authors: Javier Cortes, Javier Rodriguez, Jose Manuel Aramendia, Esteban Salgado, Alfonso Gurpide, Jesus Garcia-Foncillas, Jose Javier Aristu, Angela Claver, Ana Bosch, Jose Maria Lopez-Picazo, Salvador Martin-Algarra, Antonio Brugarolas, Emiliano Calvo
• Journal: Oncology (Oncology) Vol. 64 Issue 1 Pg. 28-35 ( 2003) ISSN: 0030-2414 [Print] Switzerland
• PMID: 12457029 (Publication Type: Journal Article)
• Copyright: Copyright 2003 S. Karger AG, Basel

Chemical References

• Deoxycytidine
• Vinblastine
• Paclitaxel
• Cisplatin
• Vinorelbine
• Gemcitabine

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Brain Neoplasms (drug therapy, mortality, secondary)
• Carcinoma, Non-Small-Cell Lung (drug therapy, mortality, secondary)
• Cisplatin (administration & dosage)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Disease-Free Survival
• Female
• Follow-Up Studies
• Humans
• Lung Neoplasms (drug therapy, mortality, pathology)
• Male
• Middle Aged
• Neoplasm Staging
• Paclitaxel (administration & dosage)
• Retrospective Studies
• Survival Rate
• Treatment Outcome
• Vinblastine (administration & dosage, analogs & derivatives)
• Vinorelbine
• Gemcitabine