TITLE:
Adjuvant Chemotherapy of Gemcitabine plus Carboplatin versus Paclitaxel plus Carboplatin in Patients with Resected Non-Small Cell Lung Cancer
AUTHORS:
Takanori Ayabe, Masaki Tomita, Kunihide Nakamura
KEYWORDS:
Non-Small Cell Lung Cancer; Gemcitabine; Paclitaxel; Carboplatin; Combination Chemotherapy; Adjuvant Therapy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.4 No.8A,
August
21,
2013
ABSTRACT: Background: This
retrospective study was to evaluate the efficacy and toxicity of gemcitabine
plus carboplatin (GC regimen) and paclitaxel plus carboplatin (PC regimen)
combination chemotherapy administered as an adjuvant therapy after complete
resection of non-small cell lung cancer. Methods: Forty-four
patients (GC regimen, n = 29; PC regimen, n = 15) received gemcitabine at a
dose of 1000 mg/m2 on days 1 and 8, and carboplatin with the target
dose of area under the curve (AUC) of 4 on day 8 every 28 days and paclitaxel
at a dose of 70 mg/m2 on days 1, 8 and 15, and carboplatin with the target
dose of AUC of 5 on day 1 every 28 days. Results: A
total of 130 cycles of the treatment were administered (averaged, 3.1 in GC arm and 2.7 cycles in PC arm).
Forty-three patients (97.7%) completed the scheduled cycles. One patient (2.3%)
was discontinued due to grade 4 pneumonia. The dose was reduced in 2 patients (4.5%) due
to grade 4 thrombocytopenia. Grade 3/4 neutropenia was significantly observed in the PC group (GC: 12/29, 41.4%; PC: 11/15,
73.3%, p = 0.0443). The
nonhematological toxicities were mild. Grade 1/2 alanine
aminotransferase and aspartate aminotransferase in the GC group was significantly observed
higher compared to those of the PC group (GC: 20/29,
69.0%; PC: 4/15, 26.7%, p = 0.0076). Grade 1/2 alopecia was significantly observed
in the PC group (GC:
0/25, 0.0%; PC: 13/15, 86.7%, p 0.0001). There was no treatment-related death.
The median survival time (MST) of the entire GC group was 784 days, the 3-year overall survival (OS) was
75.9%, and 3-year recurrence-free survival (RFS) was 65.5%. The MST of the
entire PC group was 963 days, the 3-year OS was 80.0%, and the 3-year RFS was 60.0%. Conclusion: These results demonstrate that the GC and PC combination chemotherapies
are efficacious and feasible regimens, which should be considered as one of the
standard therapies for adjuvant therapy.