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An exploratory analysis of gemcitabine/vinorelbine/cisplatin in 83 patients with advanced NSCLC in a single brazilian institution



An exploratory analysis of gemcitabine/vinorelbine/cisplatin in 83 patients with advanced NSCLC in a single brazilian institution



Journal of Clinical Oncology 26(15_Suppl): 13552-13552



NlmCategory="UNASSIGNED">13552 Background: Non Small Cell Lung Cancer is a very aggressive disease, and is still the number one cause of cancer deaths. The Lung Division of the Instituto do Cancer Dr. Arnaldo Vieira de Carvalho(ICAVC), headed by Dr. Jose Rodrigues has been very active in the lung cancer research and has collaborations with the University of Sao Paulo Lung Division for the academic development and publications of the results. It has been proven that Gemcitabine, Vinorelbine and Cisplatin are quite active agents but the survival is still poor with the doublets combination and until now, there are mixed results with the use of different triplets, specially due to additional toxicities without clear advantages. The ICAVC Lung Division has accumulated experience in the management of NSCLC with the triplet that will be described. 83 patients with stage IIIB (57 patients-68,7%) and IV(39 patients-31,3%) of NSCLC were treated in a single institution between 2000 and 2007. Males were 68,7%(57) and females were 31,3%(26). Age was 37-49 years old 14,4%(12), 50-59 y/o 38,5% (32), 60-69 y/o 31,3% (26) and more than 70 y/o was 14,4%(21). Performance KPS was 60 to 70% - 13,2% (11) and 80-100 % - 86,6% (71). Chemotherapy with 60 mg sqm of Cisplatin, 1500 mg sqm of Gemcitabine and Vinorelbine 30 mg sqm every 21 days were delivered for 4 cycles until analysis of response. After 4 cycles the Response Rate was: Stable Disease 25,3%(21); Partial Response 54,2% (45); Minimal Response 1,2%(1); Complete Response 1,2%(1); Progressive Disease 3,6% (3); Not evaluable 14,4%(12). Toxicity was tolerable, mostly hematologic that was fully recoverable. 45,8%(38) were treated just with chemotherapy, 16,9% (14) with chotherapy followed by Surgery and 45,8% (38) with chemotherapy alone. Median Survival was 312 days (44,6 weeks), media was 17,3 months (520 days) Conclusions: Chemotherapy for stage IIIB and IV with Gemcitabine, Vinorelbine and Cisplatin was given to 83 patients, the toxicity was tolerable and survival was better than historical controls. Local controls for locally advanced diseases was possible, either by chemoradiation or by tumor resection after primary chemotherapy. Combination therapy with molecular agents can improve the response rate. No significant financial relationships to disclose.

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Accession: 057181161

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PMID: 27948995


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