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Neoadjuvant Chemotherapy with Gemcitabine and Cisplatin in Stage IIIA/B Non-Small Cell Lung Cancer

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Abstract

Purpose. We studied cisplatin plusgemcitabine as induction (neoadjuvant)therapy in patients with stage IIInon-small cell lung cancer (NSCLC) toassess its objective remission rate,resectability, survival, and toxicity.

Patients and methods. Patients with stageIII NSCLC received 2 cycles of gemcitabine1250 mg/m2 on days 1, 8, and 15,plus cisplatin 100 mg/m2 on day 2.Subsequently, patients were assigned tolocal therapy – surgery or radiotherapy.

Results. Twenty-nine eligiblepatients (male/female: 21/8) with a medianage of 59 years (range, 43–71 years) wereenrolled between October 1996 and February1999. A total of 80 cycles were given,with a median of 3 per patient (range, 1–4cycles). Overall, toxicities were mild;only one patient had febrile neutropenia,and there were no grade 4 non-hematologicaltoxicities. There was one toxic deathfollowing afebrile grade 4 neutropenia.Overall clinical response rate (2 completeresponses [CRs] + 16 partial responses[PRs]) was 62% (95% CI, 45%–79%);10 patients had stable disease and noneprogressed; one patient was not evaluable.Eight of the 18 operated patients hadpathological response: 1 CR and 7downstagings to N(−); 14 patients wereresected. Median survival was 17 months(95% CI, 13–21 months), with 1-year and2-year actuarial survival rates of 61%and 29%, respectively.

Conclusions. Gemcitabine pluscisplatin is a very active andwell-tolerated induction regimen in stageIII NSCLC. Comparative studies with otherstandard regimens are warranted.

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Authors and Affiliations

  1. Alexander Fleming Institute, Buenos Aires, Argentina

    Maximiliano Van Kooten, Moisés Rosenberg, Mauro Orlando, José Morero, Carlos Silva & Reinaldo D. Chacón

  2. Hospital Ferrer, Buenos Aires, Argentina

    Maximiliano Van Kooten, Moisés Rosenberg, José Morero & Oscar Rojas

  3. Clinica Independencia, Munro, Argentina

    Manuel Vilanova & Oscar Rojas

  4. Hospital Tornú, Buenos Aires, Argentina

    Héctor Vicente & Claudia Bagnes

Authors
  1. Maximiliano Van Kooten
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  2. Moisés Rosenberg
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  3. Mauro Orlando
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  4. José Morero
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  5. Manuel Vilanova
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  10. Reinaldo D. Chacón
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Van Kooten, M., Rosenberg, M., Orlando, M. et al. Neoadjuvant Chemotherapy with Gemcitabine and Cisplatin in Stage IIIA/B Non-Small Cell Lung Cancer. Invest New Drugs 20, 439–446 (2002). https://doi.org/10.1023/A:1020618313969

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