Gemcitabine Plus Paclitaxel as Second-line Chemotherapy in Patients with Advanced Non-Small Cell Lung Cancer


Purpose: The aim of this retrospective study was to determine response rates, progression-free survival(PFS), overall survival (OS) and toxicity of gemcitabine and paclitaxel combinations with advanced or metastaticnon-small cell lung cancer patients (NSCLC) who have progressive disease after platinum-based first-linechemotherapy.
Methods: We retrospectively evaluated the file records of patients treated with gemcitabine pluspaclitaxel in advanced or metastatic NSCLC cases in a second-line setting. The chemotherapy schedule was asfollows: gemcitabine 1500 mg/m2 and paclitaxel 150 mg/m2 administered every two weeks.
Results: Forty-eightpatients (45 male, 3 female) were evaluated; stage IIIB/IV 6/42; PS0, 8.3%, PS1, 72.9%, PS2, 18.8%; medianage, 56 years old (range 38-76). Six (12.5%) patients showed a partial response (PR), 13 (27.1%) stable disease(SD), and 27 (56.3%) progressive disease (PD). The median OS was 6.63 months (95% CI 4.0-9.2); the medianPFS was 2.7 months (95% CI 1.8-3.6). Grade 3 and 4 hematologic toxicities, including neutropenia (n=4, 8.4%),and anemia (n=3, 6.3%) were encountered, but no grade 3 or 4 thrombocytopenia. One patient developed febrileneutropenia. There were no interruption for reasons of toxicity and no exitus related to therapy.
Conclusion:The combination of two-weekly gemcitabine plus paclitaxel was an effective and well-tolerated second-linechemotherapy regimen for advanced or metastatic NSCLC patients previously treated with platinum-containingchemotherapy. Although the most common and dose limiting toxicities were neutropenia and neuropathy, thisregimen was tolerated well by the patients.