A phase I/II trial of induction chemotherapy with carboplatin and gemcitabine followed by concurrent vinorelbine and paclitaxel with chest radiation in patients with stage III non-small cell lung cancer

Lung Cancer : Journal of the International Association for the Study of Lung Cancer
A ArgirisG Masters

Abstract

We designed a phase I/II trial in order to evaluate the efficacy and tolerability of induction carboplatin and gemcitabine and the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of subsequent chemoradiotherapy with weekly vinorelbine and paclitaxel in patients with stage III non-small cell lung cancer (NSCLC). Patients had pathologically confirmed N2-N3 stage NSCLC, adequate end-organ function, and ECOG performance status 0-2. Carboplatin was administered at an AUC of 5 on day 1 and gemcitabine 1000 mg/m2 on days 1 and 8, every 21 days, for two cycles, followed by weekly vinorelbine 10-15 mg/m2 and paclitaxel 50 mg/m2 and conventional chest radiotherapy up to 66 Gy. Patients with resectable disease underwent thoracotomy after 40-45 Gy. Thirty-nine eligible patients were enrolled; 17 had stage IIIB NSCLC. Grade 3 esophagitis developed in 4/5 patients on the second dose level of chemoradiotherapy (i.e. vinorelbine 15 mg/m2) and was considered dose-limiting. Of 34 patients treated at the maximum tolerated dose (i.e. vinorelbine 10 mg/m2), 2 patients (6%) had pneumonitis >grade 2 and 3 (9%), esophagitis >grade 2. Induction chemotherapy was well tolerated with only one patient developing >grade 2 non-hematologic toxic...Continue Reading

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Citations

Apr 6, 2007·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Gregory A MastersDavid Johnson
Jun 15, 2010·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Vieri ScottiGiampaolo Biti
Apr 6, 2007·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·J G J V AertsJ P van Meerbeeck
Apr 6, 2007·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Gregory A MastersColeman K Obasaju
Feb 6, 2007·International Journal of Radiation Oncology, Biology, Physics·Jingfang MaoLawrence B Marks
Mar 28, 2006·The Annals of Thoracic Surgery·Matthew G Blum, R Sudhir Sundaresan
Feb 13, 2007·International Journal of Radiation Oncology, Biology, Physics·Jingfang MaoLawrence B Marks
Dec 22, 2004·Current Treatment Options in Oncology·Ariel Birnbaum, Neal Ready
Aug 2, 2006·The Oncologist·Thomas E StinchcombeMark A Socinski

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