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A Randomized Study of Gemcitabine plus Cisplatin and Vinorelbine plus Cisplatin in Patients with Advanced Non-small-cell Lung Cancer

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Author(s): John Wen-Cheng Chang | Thomas Chang-Yao Tsao | Cheng-Ta Yang | Meng-Chih Lin | Yun-Chung Cheung | Chung-Chi Liaw | Chih-Hung Chen

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 31;
Issue: 06;
Start page: 559;
Date: 2008;
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Keywords: non-small-cell lung cancer (NSCLC) | gemcitabine | vinorelbine | cisplatin

ABSTRACT
Background: Gemcitabine plus cisplatin (GC) and vinorelbine plus cisplatin (VC) areactive and well-tolerated regimens for the treatment of patients withadvanced non-small-cell lung cancer (NSCLC). We conducted this study tocompare the safety and efficacy of these regimens as front-line chemotherapyfor patients with NSCLC.Methods: Eligible patients were randomized to receive either gemcitabine (1000mg/m2) on days 1, 8, and 15 plus cisplatin (80 mg/m2) on day 15 (arm GC),or vinorelbine (20 mg/m2) on days 1, 8, and 15 plus cisplatin (80 mg/m2) onday 15 (arm VC). Treatments were repeated every 28 days. The costs oftreatment were retrieved from the Health Care Reporting System of ChangGung Memorial Hospital at the time of final data analysis.Results: Eighty-three patients (GC, n = 39; VC, n = 44) were enrolled in the study.Seventy-three patients were analyzed. Response rates were 38% and 31%and median survivals were 12.9 and 9.0 months for the 34 patients in the GCarm and 39 patients in the VC arm, respectively. One-year survival was55.9% in the GC arm and 33.3% in the VC arm. There was no difference inthe response rate (p = 0.622), progression free survival (p = 0.443) and mediansurvival (p = 0.4197) between the two arms. Grade 3-4 toxicities werevomiting (GC: 16.3% vs VC: 36.3%), neutropenia (GC: 14.7% vs VC: 20%),and thrombocytopenia (GC: 8.68% vs VC: 5%). There was a significantincrease in all-grade thrombocytopenia (p = 0.002) in the GC arm. The GCarm had higher total expenses than the VC arm (p = 0.020).Conclusions: Both vinorelbine plus cisplatin and gemcitabine plus cisplatin yielded similarefficacies for NSCLC.

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