Short Schedule of Cisplatin and Vinorelbine: A Dose-Finding Study in Non-Small-Cell Lung Cancer

Abstract

Objectives: A dose-finding study of a new cisplatin/vinorelbine schedule was done to increase activity of the combination, and improve compliance of non-small-cell lung cancer patients. Methods: Beginning with cisplatin 40 mg/m² on days 1, 2 and vinorelbine 20 mg/m² on days 1, 3, increasing dose levels up to the maximum tolerated dose (MTD) were tested in a series of 6-patient cohorts. If 3 of 6 patients experienced dose-limiting toxicity in the first 3 cycles, the previous dose was considered the recommended dose (RD). Once the MTD was reached, granulocyte-colony-stimulating factor was prophylactically added to the treatment of a new patient cohort to improve the therapeutic ratio. Results: We enrolled 35 stage IIIA/B or IV patients between August 2001 and February 2002. The RD was cisplatin 45 mg/m² and vinorelbine 25 mg/m², with relative dose intensities (RDIs) of 95 and 97%, respectively, and an actual received dose intensity (ARDI) of 28.62 and 16.07 mg/m²/week, respectively. Overall grade 3–4 toxicities were: neutropenia (71%), febrile neutropenia (25%), anemia (8%), and constipation (17%). The overall response rate was 64.3% (CI: 44.1–81.4%). Conclusions: ARDI and RDI of our modified cisplatin/vinorelbine regimen were not inferior to those of conventional weekly schedules; its acceptable toxicity profile and manageability may justify its use in clinical practice.

Adverse drug reaction profile of cisplatin-based chemotherapy regimen in a tertiary care hospital in India

“…The occurrence of anorexia was also slightly less in the present study compared with other studies. 7,12 The frequency of constipation in the present study was 17.4%, and it is almost consistent with findings of the studies by Zucali et al 17 and by Surendiran et al 7 Though the study by Surendiran et al 7 reported diarrhea as an adverse reaction, the present study did not observe such effect. The hematological disturbances documented in the present study was lower, compared to other studies.…”

“…The hematological disturbances documented in the present study was lower, compared to other studies. 12,13,17,18 However, the frequency of anemia was almost similar with the study by Zucali et al 17 The study by Surendiran et al, 7 did not report any hematological disturbances. The frequency of increased levels of serum creatinine reported in this study was less than that observed in other previous studies.…”

Placental isoform glutathione S-transferase and P-glycoprotein expression in advanced nonsmall cell lung cancer

“…Platinum compounds still are used largely in treatment protocols for patients with advanced NSCLC in combination with other regimens. [26][27][28] Furthermore, novel treatments that target the glutathione pathway currently are under investigation. 29,30 On the basis of our results, the expression of GST-pi, P-gp, or both proteins may contribute to a more accurate prediction of outcome, giving the opportunity for better selection of patient-oriented therapy.…”