A comparison of toxicity profi le of gemcitabine monotherapy versus etoposide/cisplatin in the treatment of locally advanced or metastatic non-small cell lung cancer.
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Date
2015-01
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Abstract
Background: Lung cancer is the leading cause of cancer deaths globally in which
about 40% patients reporting in advanced stage disease. Both platinum and non
platinum combinations have been shown to be equally effi cacious as initial fi rst-line
treatment of advanced non-small cell lung cancer (NSCLC), however because of the
toxicity of cisplatin, combination treatment can only be administered to a minority
of patients in good general health. Gemcitabine could be combined with one of the
other new agents to create novel non-platinum-doublet combinations with effi cacy
and/or toxicity profi le superior to that of standard platinum based combinations.
Hence, this study was conducted to compare the toxicity profi les of gemcitabine
monotherapy and the cisplatin/etoposide combination therapy.
Methods: This was a randomized prospective study, which included 96 patients
selected on the basis of histologically or cytologically confi rmed Stage III B or IV of
NSCLC. Study was divided into two arms-Arm A received gemcitabine monotherapy
in a dose of 1000 mg/m2 on day 1 and 5 of the cycle and repeated after every 3 weeks
while Arm B received cisplatin (25 mg/m2 on day 1, 2 and 3) + etoposide (100 mg/m2).
Patient were evaluated for adverse events by following World Health Organization
grading of toxicity.
Results: Out of the 96 patients enrolled in the study, 74 (77.0%) patients were
eligible and were analyzed. Of these, 36 (37.5%) patients belonged to Arm A and
38 (39.5%) to Arm B. Transient vomiting (45.8% vs. 37.5%), leukopenia (33.3%
vs. 8.3%) were seen more in Arm A, while thrombocytopenia (33.3% vs. 12.5%),
patchy hair loss (68.4% vs. 16.6%) was seen more in Arm B. Nephrotoxicity was
seen almost similarly in both the groups.
Conclusions: Single-agent gemcitabine appears to have a safer toxicity profi le than the
combination cisplatin-etoposide in the fi rst-line chemotherapy of advanced NSCLC.
With less toxic anticancer drugs like gemcitabine, the physician now has greater
choice in choosing treatment, which can have better effect on the patients concerned.
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Keywords
Non-small cell lung cancer, Chemotherapy, Toxicity
Citation
Prakash Ved, Singh Arpita, Kant Surya, Verma Ajay K, Saxena Prachi, Bhatia Ankit. A comparison of toxicity profi le of gemcitabine monotherapy versus etoposide/cisplatin in the treatment of locally advanced or metastatic non-small cell lung cancer. International Journal of Basic & Clinical Pharmacology. 2015 Jan-Feb; 4(1): 70-74.