Unfavorable therapeutic index of cisplatin/gemcitabine/vinorelbine in advanced non-small-cell lung cancer

Paul J. Hesketh, Christopher J. Nauman, Ann M. Hesketh, Janet LaPointe, Katrina Fogarty, Thein H. Oo, Derick H Lau, Martin J. Edelman, David R Gandara

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5 Scopus citations

Abstract

In view of favorable reports with the 3-drug combination of PGV (cisplatin/gemcitabine/vinorelbine), this multicenter phase II study evaluated the therapeutic index of PGV in patients with advanced non-small-cell lung cancer (NSCLC). Thirty-two patients with stage IV NSCLC and 1 with stage IIIB were studied. There were 23 men and 10 women, with a median age of 63 years (range, 38-80 years). Twelve patients had a performance status (PS) of 0, and 21 patients had a PS of 1. Treatment consisted of cisplatin 50 mg/m2, gemcitabine 1000 mg/m2, and vinorelbine 25 mg/m2 all given intravenously on days 1 and 8, in 21-day cycles. Fifteen patients (45%; 95% confidence interval (CI), 28%-64%) achieved a partial response. Median response duration was 3 months (range, 1-9 months). The median and 1-year survival rates were 9.4 months and 39% (95% CI, 23%-58%), respectively. The median number of cycles was 4. Only 3 patients (9%) completed treatment without regimen modifications. Median dose intensity (% planned) was cisplatin 24 mg/m2/week (72%), gemcitabine 483 mg/m2/week (72%), and vinorelbine 12 mg/m2/week (72%). Toxicities were predominately hematologic, with grade 3/4 neutropenia (67%), febrile neutropenia (21%), and thrombocytopenia (67%). There were 3 (9%) treatment-related deaths due to neutropenic complications. This study confirms the substantial antineoplastic activity of PGV. We observed a high rate of severe hematologic toxicity, especially febrile neutropenia, despite a lower delivered dose intensity of PGV. Given these results, PGV appears to offer no therapeutic advantage to current doublet regimens.

Original languageEnglish (US)
Pages (from-to)47-51
Number of pages5
JournalClinical Lung Cancer
Volume4
Issue number1
StatePublished - Jul 2002

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Keywords

  • Treatment-related death
  • Triple drug combination

ASJC Scopus subject areas

  • Cancer Research
  • Pulmonary and Respiratory Medicine

Cite this

Hesketh, P. J., Nauman, C. J., Hesketh, A. M., LaPointe, J., Fogarty, K., Oo, T. H., Lau, D. H., Edelman, M. J., & Gandara, D. R. (2002). Unfavorable therapeutic index of cisplatin/gemcitabine/vinorelbine in advanced non-small-cell lung cancer. Clinical Lung Cancer, 4(1), 47-51.