Second-line chemotherapy with paclitaxel, cisplatin and gemcitabine in pre-treated sensitive cisplatin-based patients with advanced non-small cell lung cancer.
BACKGROUND
To investigate the safety and effectiveness of the combination of paclitaxel, cisplatin and gemcitabine as second-line in patients with advanced non-small cell lung cancer (NSCLC) sensitive to first-line cisplatin-based chemotherapy.


METHODS
From June 1997 to December 1998, 26 patients with stage IIIB or IV NSCLC received paclitaxel 125 mg/m2, as a one-hour infusion, followed by cisplatin 50 mg/m2 and gemcitabine 1000 mg/m2, intravenously, on day 1 and 8, every 3 weeks. Twenty-three patients were male; the median age was 59 years (range 44-70); The Eastern Cooperative Oncology Group performance status was 0 to 1 in 88% of patients; 16 patients had stage IV disease and 7 patients had 3 or more sites of disease. The predominant histology was adenocarcinoma in 14 patients. Prior treatment involved cisplatin plus vinorelbine in 14 patients and cisplatin plus mitomycin C plus vindesine in 12 cases.


RESULTS
Seven (27%; exact 95% confidence limits: 11.6-47.8%) patients achieved a partial response to treatment whilst 7 (27%) had stable disease. The median duration of response was 22 weeks (range, 18 to 34 weeks). The median overall survival was 24 weeks (range, 8 to 36 weeks). The main toxicities were: grade 3-4 neutropenia in 9 (34%) patients; grade 2-3 peripheral neuropathy in 10 (38%); and grade 2-3 asthenia in 15 (57%) cases.


CONCLUSIONS
The paclitaxel, cisplatin and gemcitabine combination is active as a second-line regimen in patients with advanced NSCLC, but with mild toxicity. It seems suitable for patients with advanced NSCLC as a first-line treatment.
Rosati
G
G
Division of Medical Oncology, S. Carlo Hospital, Potenza, Italy. rosatiger@yahoo.com
Rossi
A
A
Nicolella
G
G
Panza
N
N
D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001855:Bone Marrow Diseases / Q000139:chemically induced; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009367:Neoplasm Staging; D009422:Nervous System Diseases / Q000139:chemically induced; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D016019:Survival Analysis; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014751:Vindesine / Q000008:administration & dosage; D000077235:Vinorelbine; D000093542:Gemcitabine
D003841:Deoxycytidine; D016685:Mitomycin; D014747:Vinblastine; D017239:Paclitaxel; D002945:Cisplatin; D000077235:Vinorelbine; D014751:Vindesine; D000093542:Gemcitabine