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British Journal of Cancer logoLink to British Journal of Cancer
. 2000 Aug 17;83(6):707–714. doi: 10.1054/bjoc.2000.1341

Gemcitabine plus vinorelbine in advanced non-small cell lung cancer: a phase II study of three different doses

C Gridelli, L Frontini, F Perrone, C Gallo, M Gulisano, S Cigolari, F Castiglione, S F Robbiati, G Gasparini, G P Ianniello, A Farris, M C Locatelli, R Felletti, E Piazza; on behalf of the Gem Vin Investigators; See Appendix for complete list of Authors and Institutions
PMCID: PMC2363528  PMID: 10952772

Abstract

Our aim was to study the activity and toxicity of the gemcitabine plus vinorelbine (Gem Vin) combination and to identify the optimal dose. Previously untreated patients aged < 70 years, with stage IV or IIIb (not candidates for radiotherapy) non-small cell lung cancer were eligible. Studied dose-levels of Gem Vin, administered on days 1 and 8 every 3 weeks, were (mg m–2): level I = 1000/25; level II = 1200/25; level III = 1000/30; level IV = 1200/30. A feasibility study was performed at each dose-level, followed by a single-stage phase II study. Dose-level IV was unfeasible because of grade 4 neutropenia. Overall, out of 126 patients enrolled in phase II studies, there were one complete and 32 partial responses (response rate 26%: 95% CI 18–34%). Response rates were 27.9%, 21.4% and 29.3% at levels I, II and III, respectively. The treatment was well tolerated. Toxicity was less frequent and severe at level I. Overall median survival was 33 weeks (95% CI 28–40). Descriptive quality of life analysis showed that patients with a worse baseline global health status score tended to drop out of the study earlier than those with a better score. Gem Vin is feasible at different doses. It is sufficiently active and well tolerated. A phase III study to compare the effect on quality of life of Gem Vin (level I) vs cisplatin-based chemotherapy is ongoing. © 2000 Cancer Research Campaign

Keywords: gemcitabine, vinorelbine, non-small cell lung cancer

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Footnotes

Correspondence to: C Gridelli

Selected References

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  1. Aaronson N. K., Ahmedzai S., Bergman B., Bullinger M., Cull A., Duez N. J., Filiberti A., Flechtner H., Fleishman S. B., de Haes J. C. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993 Mar 3;85(5):365–376. doi: 10.1093/jnci/85.5.365. [DOI] [PubMed] [Google Scholar]
  2. Albain K. S., Crowley J. J., LeBlanc M., Livingston R. B. Survival determinants in extensive-stage non-small-cell lung cancer: the Southwest Oncology Group experience. J Clin Oncol. 1991 Sep;9(9):1618–1626. doi: 10.1200/JCO.1991.9.9.1618. [DOI] [PubMed] [Google Scholar]
  3. Bergman B., Aaronson N. K., Ahmedzai S., Kaasa S., Sullivan M. The EORTC QLQ-LC13: a modular supplement to the EORTC Core Quality of Life Questionnaire (QLQ-C30) for use in lung cancer clinical trials. EORTC Study Group on Quality of Life. Eur J Cancer. 1994;30A(5):635–642. doi: 10.1016/0959-8049(94)90535-5. [DOI] [PubMed] [Google Scholar]
  4. Depierre A., Chastang C., Quoix E., Lebeau B., Blanchon F., Paillot N., Lemarie E., Milleron B., Moro D., Clavier J. Vinorelbine versus vinorelbine plus cisplatin in advanced non-small cell lung cancer: a randomized trial. Ann Oncol. 1994 Jan;5(1):37–42. doi: 10.1093/oxfordjournals.annonc.a058687. [DOI] [PubMed] [Google Scholar]
  5. Feliu J., López Gómez L., Madroñal C., Espinosa E., Espinosa J., Girón C. G., Martínez B., Castro J., De la Gándara I., Barón M. G. Gemcitabine plus vinorelbine in nonsmall cell lung carcinoma patients age 70 years or older or patients who cannot receive cisplatin. Oncopaz Cooperative Group. Cancer. 1999 Oct 15;86(8):1463–1469. doi: 10.1002/(sici)1097-0142(19991015)86:8<1463::aid-cncr12>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  6. Gatzemeier U., Heckmayr M., Hossfeld D. K., Kaukel E., Koschel G., Neuhauss R. A randomized trial with mitomycin-C/ifosfamide versus mitomycin-C/vindesine versus cisplatin/etoposide in advanced non-small-cell lung cancer. Am J Clin Oncol. 1991 Oct;14(5):405–411. doi: 10.1097/00000421-199110000-00009. [DOI] [PubMed] [Google Scholar]
  7. Georgoulias V., Kouroussis C., Androulakis N., Kakolyris S., Dimopoulos M. A., Papadakis E., Bouros D., Apostolopoulou F., Papadimitriou C., Agelidou A. Front-line treatment of advanced non-small-cell lung cancer with docetaxel and gemcitabine: a multicenter phase II trial. J Clin Oncol. 1999 Mar;17(3):914–920. doi: 10.1200/JCO.1999.17.3.914. [DOI] [PubMed] [Google Scholar]
  8. Gridelli C., Perrone F., Palmeri S., D'Aprile M., Cognetti F., Rossi A., Gebbia V., Pepe R., Veltri E., Airoma G. Mitomycin C plus vindesine plus etoposide (MEV) versus mitomycin C plus vindesine plus cisplatin (MVP) in stage IV non-small-cell lung cancer: A phase III multicentre randomised trial. The "Gruppo Oncologico Centro-Sud-Isole' (G.O.C.S.I.). Ann Oncol. 1996 Oct;7(8):821–826. doi: 10.1093/oxfordjournals.annonc.a010761. [DOI] [PubMed] [Google Scholar]
  9. Isokangas O. P., Knuuttila A., Halme M., Mäntylä M., Lindström I., Nikkanen V., Viren M., Joensuu H., Mattson K. Phase II study of vinorelbine and gemcitabine for inoperable stage IIIB-IV non-small-cell lung cancer. Ann Oncol. 1999 Sep;10(9):1059–1063. doi: 10.1023/a:1008305017829. [DOI] [PubMed] [Google Scholar]
  10. Kourousis C., Androulakis N., Kakolyris S., Souglakos J., Maltezakis G., Metaxaris G., Chalkiadakis G., Samonis G., Vlachonikolis J., Georgoulias V. First-line treatment of advanced nonsmall cell lung carcinoma with docetaxel and vinorelbine. Cancer. 1998 Nov 15;83(10):2083–2090. [PubMed] [Google Scholar]
  11. Le Chevalier T., Brisgand D., Douillard J. Y., Pujol J. L., Alberola V., Monnier A., Riviere A., Lianes P., Chomy P., Cigolari S. Randomized study of vinorelbine and cisplatin versus vindesine and cisplatin versus vinorelbine alone in advanced non-small-cell lung cancer: results of a European multicenter trial including 612 patients. J Clin Oncol. 1994 Feb;12(2):360–367. doi: 10.1200/JCO.1994.12.2.360. [DOI] [PubMed] [Google Scholar]
  12. Luedke D. W., Einhorn L., Omura G. A., Sarma P. R., Bartolucci A. A., Birch R., Greco F. A. Randomized comparison of two combination regimens versus minimal chemotherapy in nonsmall-cell lung cancer: a Southeastern Cancer Study Group Trial. J Clin Oncol. 1990 May;8(5):886–891. doi: 10.1200/JCO.1990.8.5.886. [DOI] [PubMed] [Google Scholar]
  13. Manegold C., Bergman B., Chemaissani A., Dornoff W., Drings P., Kellokumpu-Lehtinen P., Liippo K., Mattson K., van Pawel J., Ricci S. Single-agent gemcitabine versus cisplatin-etoposide: early results of a randomised phase II study in locally advanced or metastatic non-small-cell lung cancer. Ann Oncol. 1997 Jun;8(6):525–529. doi: 10.1023/a:1008207731111. [DOI] [PubMed] [Google Scholar]
  14. Miller A. B., Hoogstraten B., Staquet M., Winkler A. Reporting results of cancer treatment. Cancer. 1981 Jan 1;47(1):207–214. doi: 10.1002/1097-0142(19810101)47:1<207::aid-cncr2820470134>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  15. Perng R. P., Chen Y. M., Ming-Liu J., Tsai C. M., Lin W. C., Yang K. Y., Whang-Peng J. Gemcitabine versus the combination of cisplatin and etoposide in patients with inoperable non-small-cell lung cancer in a phase II randomized study. J Clin Oncol. 1997 May;15(5):2097–2102. doi: 10.1200/JCO.1997.15.5.2097. [DOI] [PubMed] [Google Scholar]
  16. Ruckdeschel J. C., Gridelli C., Perrone F., Monfardini S., Giaccone G. Are platinum compounds mandatory in the treatment of metastatic non-small cell lung cancer? Eur J Cancer. 1998 Dec;34(13):1993–1999. doi: 10.1016/s0959-8049(98)00309-8. [DOI] [PubMed] [Google Scholar]
  17. Shinkai T., Saijo N., Tominaga K., Eguchi K., Shimizu E., Sasaki Y., Fujita J., Futami H. Comparison of vindesine plus cisplatin or vindesine plus mitomycin in the treatment of advanced non-small cell lung cancer. Cancer Treat Rep. 1985 Sep;69(9):945–951. [PubMed] [Google Scholar]
  18. Simon R., Wittes R. E., Ellenberg S. S. Randomized phase II clinical trials. Cancer Treat Rep. 1985 Dec;69(12):1375–1381. [PubMed] [Google Scholar]

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