title: [Sequential Treatment of Advanced Squamous Lung Cancer:  First-line Gemcitabine +/- platinum Followed by Second-line Taxanes +/- platinum Versus Reverse Sequence].
abstract: OBJECTIVE
  Gemcitabine and taxanes are effective agents commonly used in advanced squamous lung cancer. The best treatment sequence, however, is unclear to our knowledge. So we conducted this retrospective study in order to compare the efficacy and toxicities of first-line Gemcitabine +/- platinum followed by second-line taxanes +/- platinum with the reverse sequence.
  
  
  METHODS
  We totally analyzed 105 patients with stage IIIb-IV squamous lung cancer in our retrospective study. There were 49 patients receiving gemcitabine +/- platinum first-line followed by taxanes +/- platinum second-line (G-T group), and 56 patients receiving taxanes +/- platinum first-line followed by gemcitabine +/- platinum second-line (T-G group). The primary endpoint of the study was overall survival (OS), and the secondary endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR) and toxicities.
  
  
  RESULTS
  The median OS were 18.5 mo in G-T group and 19.0 mo in T-G group (P=0.520). The median PFS1 was 5.0 mo and 4.0 mo with first-line gemcitabine +/- platinum and taxanes +/- platinum, respectively (P=0.584). The median PFS2 was 2.7 mo and 2.5 mo with second-line gemcitabine +/- platinum and taxanes +/- platinum (P=0.432). The ORR1 of G-T group and T-G group were 36.73% and 33.92% (P=0.577), and DCR1 were 79.59% and 89.29% (P=0.186); the ORR2 of G-T group and T-G group were 4.08% and 5.36% (P=0.085), and DCR2 were 51.02% and 66.07%, respectively (P=0.118). Hematologic toxicities was more frequent in G-T group, the patients experienced more grade 3-4 lower hemoglobin (P=0.027) and thrombocytopenia (P=0.002).
  
  
  CONCLUSIONS
  The efficacy of first line gemcitabine +/- platinum followed by second line taxanes +/- platinum and the reverse sequence was similar, and the toxicities was tolerable. Both sequential patterns were effective in advanced squamous lung cancer. .
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Hongjun
authors.initials: H
authors.lastname: Gao
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Wanfeng
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Chuanhao
authors.initials: C
authors.lastname: Tang
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Jianjie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Qin
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Weixia
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Qu
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010984:Platinum / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage* / Q000009:adverse effects; D000093542:Gemcitabine
chemical_list: D043823:Taxoids; D003841:Deoxycytidine; D010984:Platinum; D000093542:Gemcitabine