Sequential chemotherapy with paclitaxel plus cisplatin, followed by vinorelbine, followed by gemcitabine in advanced non-small cell lung cancer: an Alpe-Adria Thoracic Oncology Multidisciplinary group study (ATOM 001).

Abstract

Aim of this study was to determine the activity and toxicity of a sequential chemotherapy regimen in advanced non-small cell lung cancer (NSCLC). Fifty-one previously untreated stage IIIB/IV NSCLC patients were enrolled to receive two cycles of cisplatin plus paclitaxel (80/175 mg/m(2) every 21 days), followed by two cycles of vinorelbine (30 mg/m(2) on days 1 and 8 every 21 days), followed by two cycles of gemcitabine (1000 mg/m(2) on days 1, 8, and 15 every 28 days). Forty-one patients (82%) completed the planned six cycles. Grade 3-4 neutropenia was the major toxicity (41% of patients) and it was mainly associated with vinorelbine administration. Response rate after cisplatin plus paclitaxel was 18%; this percentage increased to 41% after vinorelbine, and it reached 43% upon completion of the entire six cycle treatment program. Median survival time was 14.4 months, 1-year survival rate was 53%, and 2-year survival rate was 18%. Median time to disease progression was 6.8 months. This sequential chemotherapy regimen is feasible and active in patients with advanced NSCLC. This pilot experience provides the basis for an ongoing randomized phase III trial comparing our sequential regimen versus cisplatin plus gemcitabine.

• Authors: Francesco Grossi, Ornella Belvedere, Gianpiero Fasola, Fabio Barbone, Simona Rizzato, Angela Sibau, Leonardo Recchia, Enrico Vigevani, Tino Ceschia, Angelo Morelli, Alessandra Guglielmi, Fabio Puglisi, Alessandro Follador, Giovanni Talmassons, Alberto F Sobrero
• Journal: Lung cancer (Amsterdam, Netherlands) (Lung Cancer) Vol. 46 Issue 1 Pg. 99-106 (Oct 2004) ISSN: 0169-5002 [Print] Ireland
• PMID: 15364137 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)

Chemical References

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

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Carcinoma, Non-Small-Cell Lung (drug therapy, pathology)
• Cisplatin (administration & dosage)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Drug Administration Schedule
• Female
• Humans
• Lung Neoplasms (drug therapy, pathology)
• Male
• Middle Aged
• Neutropenia (chemically induced)
• Paclitaxel (administration & dosage)
• Survival Analysis
• Treatment Outcome
• Vinblastine (administration & dosage, analogs & derivatives)
• Vinorelbine
• Gemcitabine