Farhat Fadi S, Ghosn Marwan G, Kattan Joseph G
Department of Hematology-Oncology, Faculty of Medicine, Lebanese University, Beirut, Lebanon,
Cancer Chemother Pharmacol. 2015 Aug;76(2):235-42. doi: 10.1007/s00280-015-2785-9. Epub 2015 May 30.
Vinorelbine plus cisplatin is a commonly used doublet for the treatment of advanced non-small cell lung cancer (NSCLC). This study aimed to investigate the efficacy of oral vinorelbine as maintenance therapy in advanced NSCLC.
This multicenter phase II open-label, non-comparative study was designed to evaluate the three-weekly combination of cisplatin 80 mg/m(2) on day 1 in combination with oral vinorelbine on day 1 and 8 in advanced NSCLC.
Thirty-nine patients were enrolled; median age was 63 years (range 42-82). In the response-evaluable population (n = 38), objective response after induction therapy was observed in 18 (47 %) patients with two (5 %) patients achieving complete response. Stable disease was observed in nine (24 %) patients. The median duration of response was 6 months. Eighteen (46 %) patients received oral vinorelbine as maintenance therapy. The median PFS for the whole population and for the maintenance therapy group was 4.9 [95 % CI (2.8-6.9)] and 6.7 [95 % CI (3.7-9.7)] months, respectively, while the overall survival was 8.7 [95 % CI (5.4-11.9)] and 11 [95 % CI (8.3-13.7)] months, respectively. The main observed overall hematologic toxicities were grade 3 anemia (8 %) and grade 3/4 neutropenia (8 %).
Maintenance therapy with single-agent oral vinorelbine is feasible and well tolerated; it seems to extend the efficacy of the combination regimen with the advantage of being convenient to patients.
长春瑞滨联合顺铂是治疗晚期非小细胞肺癌(NSCLC)常用的双联方案。本研究旨在探讨口服长春瑞滨作为晚期NSCLC维持治疗的疗效。
本多中心II期开放标签、非对照研究旨在评估晚期NSCLC患者在第1天给予顺铂80mg/m²,联合第1天和第8天口服长春瑞滨,每三周一次的联合治疗方案。
共纳入39例患者;中位年龄为63岁(范围42 - 82岁)。在可评估疗效的人群(n = 38)中,诱导治疗后观察到18例(47%)患者有客观缓解,其中2例(5%)患者达到完全缓解。9例(24%)患者病情稳定。中位缓解持续时间为6个月。18例(46%)患者接受口服长春瑞滨作为维持治疗。全人群和维持治疗组的中位无进展生存期分别为4.9 [95%CI(2.8 - 6.9)]和6.7 [95%CI(3.7 - 9.7)]个月,而总生存期分别为8.7 [95%CI(5.4 - 11.9)]和11 [95%CI(8.3 - 13.7)]个月。观察到的主要血液学毒性为3级贫血(8%)和3/4级中性粒细胞减少(8%)。
单药口服长春瑞滨维持治疗可行且耐受性良好;似乎能延长联合方案的疗效,且对患者方便有利。