Feasibility study of adjuvant chemotherapy with gemcitabine and split-dose cisplatin for completely resected non-small-cell lung cancer.
BACKGROUND
Recent clinical trials have shown significant survival benefits from postoperative adjuvant chemotherapy for resected non-small-cell lung cancer (NSCLC). However, due to the comparatively low compliance in recent clinical trials, this study investigated the feasibility of adjuvant chemotherapy with gemcitabine plus split-dose cisplatin for completely resected NSCLC.


METHODS
Gemcitabine at a dose of 1000 mg m(-2) and cisplatin at 40 mg m(-2) were given intravenously on days 1 and 8 every 4 weeks for a maximum of four cycles. According to Simon's minimax two-stage design, if the regimen was judged to be safe and tolerable in five or more of the seven patients in the first stage, then enrollment would increase to a total of 20 patients. The feasibility of this regimen was proven if four cycles of chemotherapy were completed in more than 14 patients. The primary endpoint was the compliance to this regimen in the adjuvant setting, while the secondary endpoints were safety and toxicity.


RESULTS
The regimen was judged to be safe and tolerable in the first stage, and therefore 21 patients were accrued as planned. Twenty patients (95%) received four cycles of chemotherapy; therefore chemotherapy compliance in the four cycles was 95%. The relative dose intensity was 97% for both gemcitabine and cisplatin. Grade 3/4 toxicities of neutropenia occurred in 33% and thrombocytopenia in 20%. Nonhematological adverse effects were extremely rare.


CONCLUSIONS
Adjuvant chemotherapy with gemcitabine and split-dose cisplatin showed a favorable feasibility and acceptable toxicity in Japanese NSCLC patients.
Funai
Kazuhito
K
Division of Thoracic Surgery, Hamamatsu Medical Center, Hamamatsu, Japan. kfunai@hmedc.or.jp
Takamochi
Kazuya
K
Itaya
Toru
T
Mochizuki
Takahiro
T
Nakamura
Toru
T
Toyoda
Futoru
F
Yong-Il
Kim
K
Sasaki
Kazuyoshi
K
Momiki
Shigeru
S
Takahashi
Tsuyoshi
T
Neyatani
Hiroshi
H
Suzuki
Kazuya
K
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D054796:Drug Dosage Calculations; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000209:etiology; D010349:Patient Compliance; D011013:Pneumonectomy; D011446:Prospective Studies; D013921:Thrombocytopenia / Q000209:etiology; D000093542:Gemcitabine
D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine