Department of Thoracic Oncology Hyogo Cancer Center, Akashi, Hyogo, Japan.
J Thorac Oncol. 2010 May;5(5):696-701. doi: 10.1097/JTO.0b013e3181d0a46a.
This study was conducted to evaluate the efficacy and safety and to compare dosing schedules of gemcitabine combined with S-1 in chemo-naïve non-small cell lung cancer patients.
Patients with chemo-naïve stage IIIB/IV non-small cell lung cancer were randomized into two treatment arms. Patients were given oral S-1 (60 mg/m/d, twice a day) from days 1 to 14 with gemcitabine (1000 mg/m/d) on days 1 and 8 (arm A) or on days 8 and 15 (arm B). This cycle was repeated every 21 days.
A total of 80 patients were entered in this trial. The primary end point of this study was response rate. The response rates of arm A and arm B were 22.0 and 28.9%, respectively (p = 0.606). Median time to treatment failure in arm A was 3.6 months and 4.8 months in arm B. Median time to progression in arm A was 4.1 months and 5.5 months in arm B. Median survival time in arm A and arm B was 15.5 months and 18.8 months, respectively. The toxicity profile was relatively mild and did not differ very much between two arms.
The combination of gemcitabine and S-1 was determined to be feasible and effective for advanced non-small cell lung cancer. We selected arm B for further studies because of its higher response rate and survival data.
本研究旨在评估吉西他滨联合 S-1 在未经化疗的非小细胞肺癌患者中的疗效和安全性,并比较两种给药方案。
将未经化疗的 IIIB/IV 期非小细胞肺癌患者随机分为两组。患者在第 1 至 14 天给予口服 S-1(60 mg/m/d,每日 2 次),第 1 和 8 天(A 组)或第 8 和 15 天(B 组)给予吉西他滨(1000 mg/m/d)。每 21 天重复一个周期。
本试验共纳入 80 例患者。该研究的主要终点为缓解率。A 组和 B 组的缓解率分别为 22.0%和 28.9%(p=0.606)。A 组的治疗失败时间中位数为 3.6 个月,B 组为 4.8 个月。A 组的疾病进展时间中位数为 4.1 个月,B 组为 5.5 个月。A 组和 B 组的中位生存时间分别为 15.5 个月和 18.8 个月。毒性谱相对较轻,两组之间差异不大。
吉西他滨联合 S-1 对晚期非小细胞肺癌是可行且有效的。由于 B 组的缓解率和生存数据更高,我们选择 B 组进行进一步研究。