Flexible chemotherapy regimen with gemcitabine and vinorelbine for metastatic nonsmall cell lung carcinoma - A phase II multicenter trial

BACKGROUND. This Phase II study evaluated a flexible 3- or 4-week dosing sc hedule of gemcitabine and vinorelbine to determine its effect on response r ate and survival of patients with metastatic nonsmall cell lung carcinoma ( NSCLC). METHODS. Thirty-four response-evaluable patients, 24 with performance statu s (PS) 0-1 and 10 with a PS of 2, 30 with Stage IV, and 4 with Stage IIIB N SCLC were treated with gemcitabine 1000 mg/m(2) intravenously and vinorelbi ne 25 mg/m2 intravenously (first 15 patients) or 30 mg/m2 intravenously (ne xt 19 patients) on Days 1, 8, and 15 of a 4-week cycle, if on Day 15 neutro phils were greater than or equal to 1500/uL end platelets greater than or e qual to 100,000/uL. If chemotherapy could not be administered on Day 15, th en Day 22 became Day I of the next cycle. RESULTS. When vinorelbine 25 mg/m2 was given with gemcitabine 1000 mg/m2, 1 1 patients received 4-week cycles, 3 patients 3-week cycles, and 1 patient both 3- and 4-week cycles. With vinorelbine 30 mg/m2 and gemcitabine 1000 m g/m2, 7 patients received 4-week cycles, 2 patients 3-week cycles, and 10 p atients both 3- and 4-week cycles. The partial response rate for 34 patient s was 53% (18 patients). Median survival (MS) was 11.1 months, and 1-year s urvival 50% (17 patients). Patients with PS 0+1 had a MS of 17.5 months com pared with patients with PS 2, who had MS of 3.3 months. Patients < 70 year s of age had a MS of 18 months, and those > 70 years had a MS of 5.5 months . CONCLUSION. This flexible schedule with gemcitabine and vinorelbine enabled optimal dose delivery and suggested excellent efficacy but less toxicity t han treatment with platinum regimens. (C) 2001 American Cancer Society.