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Nonplatinum Doublet Effective in Non-Small-Cell Lung Cancer

Nonplatinum Doublet Effective in Non-Small-Cell Lung Cancer

NEW YORK— A combination of vinorelbine (Navelbine) and gemcitabine (Gemzar)
showed similar efficacy to the standard platinum-based regimen for advanced
non-small-cell lung cancer (NSCLC) and a different toxicity profile in a
phase II study presented at the Mount Sinai School of Medicine Chemotherapy
Foundation Symposium XX.

Rogerio C. Lilenbaum, MD, clinical associate professor of medicine,
University of Miami School of Medicine, and director, Thoracic Oncology
Program, Mount Sinai Comprehensive Cancer Center, Miami Beach, presented
preliminary results from a multicenter randomized trial that enrolled 164
lung cancer patients.

All patients had histologically proven stage IIIB or IV non-small-cell
lung cancer and had not previously received chemotherapy. Patients with brain
metastases were eligible for the trial, provided they were neurologically

"Most patients had stage IV disease," Dr. Lilenbaum said, "and most
patients had performance status 0 to 1. About 15% had performance status 2."

Patients were randomized to receive carboplatin (Paraplatin) at a dose of
AUC 6 and paclitaxel (Taxol) at 200 mg/m2 on the first day of each cycle or
vinorelbine 25 mg/m2 and gemcitabine 1,000 mg/m2 on days 1 and 8 of each
cycle. For both regimens, the cycles were 21 days and were repeated up to a
maximum of six times. The median number of cycles completed was approximately
four, Dr. Lilenbaum said.

Outcome were similar in both arms, with no significant differences.
Partial responses were achieved in 14.6% of patients in the vinorelbine/gemcitabine
arm and 17.1% in the carboplatin/paclitaxel arm. Stable disease was recorded
in 37.8% and 35.4%, and disease progression was seen in 34.1% and 31.7%,
respectively. The median time to progression was 2.1 months in both groups.

Median survival was 7.3 months with vinorelbine/gemcitabine and 8.4 months
with the platinum-based therapy.


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