Randomized study of vinorelbine–gemcitabine versus vinorelbine–carboplatin in patients with advanced non-small cell lung cancer

Tan, Eng Huat; Szczęsna, Aleksandra; Krzakowski, Maciej; Macha, H.-N.; Gatzemeier, U.; Mattson, K.; Wernli, Martin; Reiterer, Pavel; Hui, Rina; Pawel, Joachim von; Bertetto, Oscar; Pouget, Jean-Christophe; Burillon, J.P.; Parlier, Y.; Abratt, Raymond P.

doi:10.1016/j.lungcan.2005.03.029

Cited by 49 publications

(46 citation statements)

References 19 publications

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“…In contrast, the markedly higher incidence of grade 3 -4 anaemia (19 vs 6%) and thrombocytopenia (44 vs 3%) in the GC arm led to additional symptoms and significantly more frequent transfusions of blood products, requiring hospitalisation and further costs. Haematological toxicity following VC treatment of 159 advanced NSCLC patients was reported by Tan et al (2005). In this study, the vinorelbine dose was higher (30 mg m À2 ), and inclusion criteria were more restricted with Karnofsky PSX80 and age o75.…”

Section: Discussionmentioning

confidence: 86%

“…For vinorelbine/platinum combinations, recent phase III studies have yielded median survival data ranging from 6.5 to 11 months (Wozniak et al, 1998;Kelly et al, 2001;Scagliotti et al, 2002;Fossella et al, 2003;Gebbia et al, 2003;Georgoulias et al, 2005;Martoni et al, 2005;Tan et al, 2005;Plessen et al, 2006). In the gemcitabine/platinum metaanalysis (Le Chevalier et al, 2005), median survival in the gemcitabine group was 9 months, reflecting the mean value for a number of studies (Le Chevalier et al, 1994;Cardenal et al, 1999;Sandler et al, 2000;Scagliotti et al, 2002;Schiller et al, 2002;Alberola et al, 2003;Gebbia et al, 2003;Smit et al, 2003;Zatloukal et al, 2003;Martoni et al, 2005;Rudd et al, 2005;Sederholm et al, 2005).…”

Section: Discussionmentioning

confidence: 98%

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Vinorelbine/carboplatin vs gemcitabine/carboplatin in advanced NSCLC shows similar efficacy, but different impact of toxicity

et al. 2007

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This randomised phase III study in advanced non-small cell lung cancer (NSCLC) patients was conducted to compare vinorelbine/ carboplatin (VC) and gemcitabine/carboplatin (GC) regarding efficacy, health-related quality of life (HRQOL) and toxicity. Chemonaive patients with NSCLC stage IIIB/IV and WHO performance status 0 -2 were eligible. No upper age limit was defined. Patients received vinorelbine 25 mg m À2 or gemcitabine 1000 mg m À2 on days 1 and 8 and carboplatin AUC4 on day 1 and three courses with 3-week cycles. HRQOL questionnaires were completed at baseline, before chemotherapy and every 8 weeks until 49 weeks. During 14 months, 432 patients were included (VC, n ¼ 218; GC, n ¼ 214). Median survival was 7.3 vs 6.4 months, 1-year survival 28 vs 30% and 2-year survival 7 vs 7% in the VC and GC arm, respectively (P ¼ 0.89). HRQOL, represented by global QOL, nausea/vomiting, dyspnoea and pain, showed no significant differences. More grade 3 -4 anaemia (Po0.01), thrombocytopenia (Po0.01) and transfusions of blood (Po0.01) or platelets (Po0.01) were observed in the GC arm. There was more grade 3 -4 leucopoenia (Po0.01) in the VC arm, but the rate of neutropenic infections was the same (P ¼ 0.87). In conclusion, overall survival and HRQOL are similar, while grade 3 -4 toxicity requiring interventions are less frequent when VC is compared to GC in advanced NSCLC.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 98%

Vinorelbine/carboplatin vs gemcitabine/carboplatin in advanced NSCLC shows similar efficacy, but different impact of toxicity

et al. 2007

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“…[5][6][7][8][9][10] Previous chemotherapy regimens as second-line therapy included the following: GEM plus VNR (n = 1), PEM 500 mg/m 2 (n = 1), and DOC 60 mg/m 2 (n = 1). 11,12 In four postoperative patients who underwent adjuvant therapy, two patients received tegafur-uracil, one patient was treated with CBDCA and PEM, and one patient was administered CDDP and PEM (Table 2).…”

Section: Previous Chemotherapymentioning

confidence: 99%

Gefitinib frequently induces liver damage in patients with lung adenocarcinoma previously treated by chemotherapy

Sugiura¹,

Nemoto²,

Kawai³

et al. 2013

LCTT

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Background: Gefitinib is known as one of the agents for treating patients with both advanced lung cancer and an epidermal growth-factor receptor mutation. In the epidermal growth-factor receptor-mutant advanced non-small-cell lung cancer population, gefitinib therapy has been associated with increased response rate, longer progression-free survival, and better quality of life compared to other anticancer drugs. However, gefitinib has to be discontinued for patients in whom adverse events occur, even if it is still effective. Here, we retrospectively assessed the clinical course of patients receiving gefitinib therapy, with a particular focus on liver damage. Patients and methods: Of 24 Asian patients treated with 250 mg gefitinib daily at Kanagawa National Hospital, Japan, between January 2008 and June 2012, grade 3 liver damage (Common Terminology Criteria for Adverse Events, version 4.0) occurred in nine and were eligible for our assessment. The regimen was subsequently changed to alternate-day administration. The relationships between liver damage and each clinical factor were retrospectively examined using Fisher's exact test. Results: Of the nine patients with liver damage, seven had previous exposure to another anticancer drug. There was a significant relationship between the incidence of liver damage and previous chemotherapy (P = 0.009). The objective response rates of patients treated with daily gefitinib 250 mg and alternate-day gefitinib following liver damage were 66.7% and 46.7%, respectively; these were not significantly different (P = 0.597). Conclusion: Gefitinib for advanced adenocarcinoma patients who have previously undergone chemotherapy should be used cautiously and liver function monitored closely, because it frequently induces significant liver damage. The alternate-day administration of gefitinib may be a suitable option for patients in whom daily gefitinib therapy induces liver damage.

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“…All other societies recommend first-line platinum-based chemotherapy for advanced NSCLC patients. There are multiple randomised published trials on this topic [71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90]. In terms of survival, there is no statistically significant difference between the two types of treatment in all but one trial.…”

Section: Lung Cancer Chemotherapy J-p Sculier and D Moro-sibilotmentioning

confidence: 99%

First- and second-line therapy for advanced nonsmall cell lung cancer

Sculier¹,

Moro-Sibilot²

2009

European Respiratory Journal

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The objectives for the treatment of advanced nonsmall cell lung cancer are palliative and include improvement of survival, symptom control, quality of life and cost. The level of evidence of these benefits is based on multiple randomised trials and meta-analyses. Cisplatinbased chemotherapy with one of the regimens shown to be effective should be preferred. Carboplatin may be substituted for cisplatin if medical contraindications exist. Nonplatinumbased regimens are indicated as first-line treatment for advanced nonsmall cell lung cancer in patients for whom platinum-based chemotherapy is contraindicated. Single drug chemotherapy may be considered in patients with poor performance status. The choice of the active drugs depends on the patient's medical condition. There is no conclusive evidence that high doses of cisplatin (100-120 mg?m -2 ) provide better results than standard lower doses (50-60 mg?m -2 ) in terms of survival. The optimal duration of chemotherapy is poorly documented in advanced nonsmall cell lung cancer. A minimum of four to six cycles is advised in responding patients. Second-line chemotherapy is now accepted as a standard and should be offered to patients with good performance status and failing platinum-based first-line chemotherapy. Evidence is in favour of docetaxel and in the case of adenocarcinoma and adequate renal function, pemetrexed is recommended.

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Randomized study of vinorelbine–gemcitabine versus vinorelbine–carboplatin in patients with advanced non-small cell lung cancer

Cited by 49 publications

References 19 publications

Vinorelbine/carboplatin vs gemcitabine/carboplatin in advanced NSCLC shows similar efficacy, but different impact of toxicity

Vinorelbine/carboplatin vs gemcitabine/carboplatin in advanced NSCLC shows similar efficacy, but different impact of toxicity

Gefitinib frequently induces liver damage in patients with lung adenocarcinoma previously treated by chemotherapy

First- and second-line therapy for advanced nonsmall cell lung cancer

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