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Karampeazis A, Vamvakas L, Kentepozidis N, Polyzos A, Chandrinos V, Rigas G, Christofyllakis C, Kotsakis A, Hatzidaki D, Pallis AG, Georgoulias V. Biweekly Carboplatin Plus Gemcitabine as First-Line Treatment of Elderly Patients With Advanced Squamous Non-Small-cell Lung Cancer: A Multicenter Phase I-II Trial by the Hellenic Oncology Research Group. Clin Lung Cancer 2016; 17:543-549. [PMID: 27397849 DOI: 10.1016/j.cllc.2016.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 05/20/2016] [Accepted: 05/24/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND The present study was a phase I/II study to determine the maximum tolerated doses (MTDs) and dose-limiting toxicities of the biweekly carboplatin/gemcitabine combination and evaluate its safety and efficacy in patients aged ≥ 70 years with advanced squamous non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Patients aged ≥ 70 years with advanced or metastatic squamous NSCLC received escalated doses of carboplatin (area under the curve [AUC] 2-2.5 intravenously) and gemcitabine (800-1100 mg/m2 intravenously) every 2 weeks (phase I). In the phase II, the drugs were administered at their previously defined MTDs (carboplatin, AUC 2.5; gemcitabine, 1100 mg/m2). The primary endpoint was the overall response rate. RESULTS A total of 69 patients were enrolled (phase I, n = 15). The median age was 76 years (range, 70-84 years); 52 patients had stage IV disease, and 61 and 8 patients had Eastern Cooperative Oncology Group performance status of 0 to 1 and 2, respectively. The MTDs could not be reached at the predefined last dose levels. The dose-limiting toxicities were grade 5 renal toxicity and grade 3 thrombocytopenia. In the phase II study, the overall response rate was 35.8% (95% confidence interval [CI], 23.0%-48.8%). In the intention-to-treat analysis, the median progression-free survival was 6.7 months (95% CI, 4.2-8.8 months), and the median overall survival was 13.3 months (95% CI, 7.1-19.6 months). Grade 3 or 4 neutropenia was observed in 7 patients (12.3%), grade 3 or 4 thrombocytopenia in 4 patients (7.1%), and grade 2 or 3 fatigue in 10 patients (17.5%). One toxic death occurred in the phase I of the study. CONCLUSION The biweekly regimen of gemcitabine and carboplatin showed satisfactory efficacy and a favorable toxicity profile in elderly patients with advanced or metastatic squamous cell NSCLC.
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Affiliation(s)
- Athanasios Karampeazis
- 401 Army General Hospital, Athens, Greece; Laboratory of Tumor Cell Biology, School of Medicine, University of Crete, Heraklion, Crete, Greece; Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - Lambros Vamvakas
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece; Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Nikolaos Kentepozidis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece; Medical Oncology Department, 251 General Air Force Hospital, Athens, Greece
| | - Aris Polyzos
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece; 1st Department of Medicine, Medical School, University of Athens, Laikon General Hospital, Athens, Greece
| | - Vassilis Chandrinos
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece; 1st Department of Pulmonary Disease, Sismanoglion Hospital, Athens, Greece
| | - Georgios Rigas
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece; Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Charalambos Christofyllakis
- 401 Army General Hospital, Athens, Greece; Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - Athanasios Kotsakis
- Laboratory of Tumor Cell Biology, School of Medicine, University of Crete, Heraklion, Crete, Greece; Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece; Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Crete, Greece
| | - Dora Hatzidaki
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - Athanasios G Pallis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - Vassilis Georgoulias
- Laboratory of Tumor Cell Biology, School of Medicine, University of Crete, Heraklion, Crete, Greece; Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), Athens, Greece.
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