What is the best drug in combination with a platinum-derivative in the treatment of advanced non-small cell lung cancer (NSCLC)? A gemcitabine (G)/vinorelbine (V) retrospective study

• DOI: 10.1200/jco.2004.22.90140.7295
• Publication Date: 2017-04-05T03:17:42Z
• Authors: P. Barradas; A. Costa; M. Cristóvão; A. P. Alves; A. S. Oliveira; I. Faria; M. J. Melo
• Keywords: Vinorelbine; Carboplatin; Performance status

7295 Background: Although combinations of platinum-derivatives with G or V were largely used in the treatment NSCLC, very few studies directly comparing these associations available. Methods: We retrospectively compared results all patients (pts) advanced NSCLC and performance status (PS) ≤2 treated our unit during 7 years regimens (1000 mg/m2/w) (30 plus a platinum derivative. 249 pts from randomized trials (not associations) 263 on clinical-practice basis. Results: From 1/97–10/03, 512 (342) (170) The groups well balanced age, sex, histology, PS, stage, Cyfra 21–1 baseline median levels. Cisplatin (P) carboplatin (C) for about 60% (308) 40% (204) pts, respectively. Mean dose-intensities P (G 24.6; 24.8 mg/m2/wk) C AUC 5.2; 5.3) similar both groups. dose intensities 641 mg/m2/wk 19.2 mg/m2/wk, Hematologic toxicity was between except grade 3–4 thrombocytopenia more frequent G-based 24% vs 4%; p<.001). Median follow-up (40 mo) ORR significantly higher (38.3%; 95 CI 33.1–43.5%) than (29.4%; 22.5–36.3%; p=.049). had survival 11.6 mo 9.0 mo; p=.005), time to progression 6.2 4.4 p=.019) 1, 2 3-year rates 49, 19 10% 34, 10 6%, respectively; p=.016, .025, .044). These differences are significant stage III IV (p=.034 .012) (p=.032 Kaplan-Meier curves also favored (log-rank p=.0056), which still pronounced after adjustment (using Cox's model) main prognostic factors p=.0031). Conclusions: In derivative is efficacious when platinum-derivative. must be confirmed large trial meta-analysis. No financial relationships disclose.