Clinical experience with single-agent gemcitabine chemotherapy in patients with non-small-cell lung cancer in whom previous chemotherapy has failed.
BACKGROUND
In a phase II study, responses and toxicity to single-agent gemcitabine chemotherapy were evaluated in patients with non-small-cell lung cancer (NSCLC) who had failed previous cisplatin-based chemotherapy.


METHODS
Twenty patients were enrolled from December 2001 to December 2003: 17 of them had received first-line cisplatin-based regimens and second-line docetaxel treatment; and 3 had previously received cisplatin plus paclitaxel. Study treatment comprised an intravenous infusion of gemcitabine 1200 mg/m2 on days 1, 8, and 15 of each 4-week cycle.


RESULTS
Fifty-seven cycles of treatment were given (mean, 2.9 cycles per patient). All patients were evaluable for toxicity profile, and 16 were evaluable for response rate. The principal toxicity was myelosuppression: grade 3 neutropenia occurred in 2 patients (10%), thrombocytopenia in 3 (15%), and anemia in 1 (5%). Other toxicities were few and mild in severity. After 2 cycles of treatment, 2 of 16 patients (12.5%) had a partial response. The median time to disease progression was 2.1 months, and median survival time was 7.5 months. The 1-year survival rate was 36%.


CONCLUSIONS
Salvage, single-agent chemotherapy with gemcitabine has modest activity, is well tolerated, and yields good survival in NSCLC patients who have failed previous chemotherapy. Such single-agent therapy may therefore be suggested for use in patients with good performance status who ask for further chemotherapy, when disease progresses after cisplatin-based therapy, but especially after second-line docetaxel therapy.
Chen
Yuh-Min
YM
Chest Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. ymchen@vghtpe.gov.tw
Tsai
Chun-Ming
CM
Perng
Reury-Perng
RP
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000627:therapeutic use; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine