Ng E W, Sandler A B, Robinson L, Einhorn L H
Department of Medicine, Section of Hematology-Oncology, Indiana University, Indianapolis, USA.
Am J Clin Oncol. 1999 Dec;22(6):550-3. doi: 10.1097/00000421-199912000-00003.
The purpose of this study was to evaluate the toxicity and determine the response rate, duration of remission, and survival using gemcitabine plus carboplatin in non-small cell lung cancer (NSCLC). This was a phase II study of gemcitabine and carboplatin in chemotherapy-naive patients with advanced NSCLC and Karnofsky Performance Status of at least 80. Gemcitabine was administered intravenously at 1,000 mg/m2 weekly for 3 weeks followed by 1 week rest. Carboplatin was administered immediately after gemcitabine at an area under the curve (AUC) of 5 given intravenously on day 1 of an every-4-week cycle. Seven patients were entered in the study and five were evaluable for toxicity. The median age of patients was 68 years (range, 52-72). The protocol was prematurely terminated because of severe and unexpected hematologic toxicity. Grade 3-4 thrombocytopenia was observed in four of the first five patients. These toxicities were all observed with the first course of chemotherapy. There were no objective responses seen. Median survival time was 130 days. Carboplatin plus gemcitabine was a logical combination. However, because of the severe thrombocytopenia associated with this regimen, we do not recommend this two-drug combination in the dose and schedule used in this study.
本研究的目的是评估吉西他滨联合卡铂治疗非小细胞肺癌(NSCLC)的毒性,并确定缓解率、缓解持续时间和生存率。这是一项针对初治的晚期NSCLC且卡氏评分至少为80的患者进行的吉西他滨和卡铂的II期研究。吉西他滨以1000mg/m²的剂量静脉注射,每周1次,共3周,随后休息1周。在每4周一个周期的第1天,吉西他滨给药后立即静脉注射卡铂,曲线下面积(AUC)为5。7名患者进入研究,5名患者可评估毒性。患者的中位年龄为68岁(范围52 - 72岁)。由于严重且意外的血液学毒性,该方案提前终止。在前5名患者中有4名观察到3 - 4级血小板减少。这些毒性均在化疗的第一个疗程时出现。未观察到客观缓解。中位生存时间为130天。卡铂加吉西他滨是一种合理的联合用药。然而,由于该方案伴有严重的血小板减少,我们不推荐本研究中使用的剂量和给药方案的这种两药联合。