Abstract | BACKGROUND: PATIENTS AND METHODS: Patients with advanced (stages IIIB-IV) NSCLC received up to six 21-day cycles of Lipoplatin 120 mg/m(2) (days 1, 8, 15) and gemcitabine 1000 mg/m(2) (days 1+8) (arm A; LipoGem) versus cisplatin 100mg/m(2) (day 1) and gemcitabine 1000 mg/m(2) (days 1+8) (arm B; CisGem). The primary objective was objective response rate (ORR). Secondary objectives were disease control rate (DCR), progression-free survival (PFS), duration of response and overall survival (OS). Another secondary objective was safety and tolerability of the LipoGem combination. RESULTS: Eighty-eight patients (n=88) entered the study; 47 patients were treated with LipoGem versus 41 patients treated with CisGem. Efficacy was assessed in patients who completed at least 1 cycle of treatment; ORR was 31.7% in arm A versus 25.6% in arm B and DCR was 70.7% versus 56.4%, respectively. A preliminary efficacy of LipoGem versus CisGem in the adenocarcinoma histological subtype of NSCLC showed 16.7% versus 45.8% PD. Treatment in arm A was better tolerated with myelotoxicity and a transient mild elevation of serum creatinine as the dominant side effects; the only grade 4 adverse event was neutropenia noted in 2% of the patients. There was a significant reduction in nephrotoxicity in the LipoGem arm (0% versus 5% grade III, p-value<0.001) as well as in nausea vomiting (2% versus 12% grade III, p-value<0.001). In addition, less antiemetics and G-CSF were administered in arm A. CONCLUSION: Overall, Lipoplatin appears to have lower toxicity, mainly renal toxicity as well as higher efficacy than cisplatin when combined with gemcitabine in advanced NSCLC.
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Authors | N Mylonakis, A Athanasiou, N Ziras, J Angel, A Rapti, S Lampaki, N Politis, C Karanikas, C Kosmas |
Journal | Lung cancer (Amsterdam, Netherlands)
(Lung Cancer)
Vol. 68
Issue 2
Pg. 240-7
(May 2010)
ISSN: 1872-8332 [Electronic] Ireland |
PMID | 19628292
(Publication Type: Clinical Trial, Phase II, Comparative Study, Journal Article, Randomized Controlled Trial)
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Copyright | Copyright 2009 Elsevier Ireland Ltd. All rights reserved. |
Chemical References |
- lipoplatin
- Deoxycytidine
- Creatinine
- Cisplatin
- Gemcitabine
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Topics |
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Carcinoma, Non-Small-Cell Lung
(blood, drug therapy, pathology, physiopathology)
- Cisplatin
(administration & dosage, adverse effects)
- Creatinine
(blood)
- Deoxycytidine
(administration & dosage, adverse effects, analogs & derivatives)
- Female
- Humans
- Lung Neoplasms
(blood, drug therapy, pathology, physiopathology)
- Male
- Middle Aged
- Neoplasm Staging
- Neutropenia
(etiology)
- Gemcitabine
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