title: 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.affiliation: Disease Management Team-Lung Cancer, Medical Oncology A, National Institute for Cancer Research, Largo R. Benzi 10, 16132 Genoa, Italy. francesco.grossi@istge.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Grossi
authors.forename: Ornella
authors.initials: O
authors.lastname: Belvedere
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Fasola
authors.forename: Fabio
authors.initials: F
authors.lastname: Barbone
authors.forename: Simona
authors.initials: S
authors.lastname: Rizzato
authors.forename: Angela
authors.initials: A
authors.lastname: Sibau
authors.forename: Leonardo
authors.initials: L
authors.lastname: Recchia
authors.forename: Enrico
authors.initials: E
authors.lastname: Vigevani
authors.forename: Tino
authors.initials: T
authors.lastname: Ceschia
authors.forename: Angelo
authors.initials: A
authors.lastname: Morelli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Guglielmi
authors.forename: Fabio
authors.initials: F
authors.lastname: Puglisi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Follador
authors.forename: Giovanni
authors.initials: G
authors.lastname: Talmassons
authors.forename: Alberto F
authors.initials: AF
authors.lastname: Sobrero
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D017239:Paclitaxel / Q000008:administration & dosage; D016019:Survival Analysis; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077235:Vinorelbine; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D014747:Vinblastine; D017239:Paclitaxel; D002945:Cisplatin; D000077235:Vinorelbine; D000093542:Gemcitabine