BMC Cancer | |
A phase II study of cisplatin with intravenous and oral vinorelbine as induction chemotherapy followed by concomitant chemoradiotherapy with oral vinorelbine and cisplatin for locally advanced non-small cell lung cancer | |
Delphine Lerouge10  Alain Rivière10  Eric Dansin4  Christos Chouaid8  Cécile Dujon5  Roland Schott1  Armelle Lavole13  Vincent Le Pennec7  Elizabeth Fabre12  Jacky Crequit11  Francis Martin6  Stéphanie Dehette6  Pierre Fournel3  Bénédicte Precheur-Agulhon2  Eric Lartigau4  Gérard Zalcman9  | |
[1] Department of Pneumology, Centre P. Strauss, Strasbourg, France | |
[2] Institut de Recherche Pierre Fabre, Boulogne-Billancourt, France | |
[3] Department of Pneumology, Institut de Cancérologie Lucien Neuwirth, Saint-Etienne, France | |
[4] Department of Pneumology, Centre O. Lambret, Lille, France | |
[5] Department of Oncology, Hôpital A. Mignot, Le Chesnay, France | |
[6] Department of Pneumology, Centre hospitalier, Compiègne, France | |
[7] Department of Radiology, Centre Hospitalier Universitaire de Caen, Caen, France | |
[8] Department of Pneumology, Centre hospitalier Intercommunal de Créteil, Créteil, France | |
[9] Deparment of Pneumology and Thoracic Oncology, Centre Hospitalier Universitaire de Caen, France | |
[10] Department of Oncology radiotherapy, CRLCC F. Baclesse, Caen, France | |
[11] Department of Pneumology, Centre Hospitalier de Creil, Creil, France | |
[12] Department of Medical Oncology, Hôpital européen G Pompidou, Paris, France | |
[13] Department of Pneumology, Hôpital Tenon, Paris, France | |
关键词: Chemoradiotherapy; Oral vinorelbine; Locally advanced non-small cell lung cancer; | |
Others : 858927 DOI : 10.1186/1471-2407-14-231 |
|
received in 2013-05-04, accepted in 2014-03-25, 发布年份 2014 | |
【 摘 要 】
Background
Concomitant platinum-based chemotherapy and radiotherapy (CT-RT) is the recommended treatment for unresectable locally advanced stage III non-small cell lung cancer (NSCLC). We conducted a phase II study to evaluate the efficacy and safety of fractionated oral vinorelbine with cisplatin as induction CT followed by CT-RT.
Methods
Patients with stage III NSCLC received 2 induction cycles of intravenous vinorelbine 25 mg/m2 and cisplatin 80 mg/m2 on day 1 and oral vinorelbine 60 mg/m2 on day 8. Responding patients received 2 more cycles of cisplatin 80 mg/m2 on day 1 and oral vinorelbine 20 mg on days 1, 3 and 5 concomitantly with radiotherapy 2 Gy daily, 5 days/week for a total of 66 Gy.
Results
Seventy patients, median age 61 years, were enrolled. Overall response rate (ORR) was 50.0%; Disease Control Rate was 81.42%. Median PFS was 14.58 months [95% CI, 10.97-18.75]. Median OS was 17.08 months [95% CI, 13.57-29.57]. One-year and 2-year survival rates were 68.6% [95% CI, 57.7-79.4] and 37%. One patient had a grade 3 pulmonary radiation injury and 26.5% had graded 1/2 esophagitis.
Conclusion
In non-operable IIIA-IIIB NSCLC, the combination oral vinorelbine (fractionated fixed dose) plus cisplatin, during concomitant CT-RT, could offer a well-tolerated option, with comparable activity to I.V. vinorelbine-based chemoradiotherapy regimens.
Trial registration
ClinicalTrials.gov, NCT01839032
【 授权许可】
2014 Lerouge et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20140724055418878.pdf | 677KB | download | |
16KB | Image | download | |
23KB | Image | download | |
70KB | Image | download | |
73KB | Image | download |
【 图 表 】
【 参考文献 】
- [1]Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM: Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010, 127(12):2893-2917.
- [2]INCa 2010 La situation du cancer en France en 2010: Collection Rapports & Synthèses Ed. INC. Paris; 2010.
- [3]Alberg AJ, Brock MV, Samet JM: Epidemiology of lung cancer: looking to the future. J Clin Oncol 2005, 23(14):3175-3185.
- [4]Crino L, Weder W, van Meerbeeck J, Felip E: ESMO guidelines working group. Ann Oncol 2010, 21(suppl5):v103-v115.
- [5]Robinson LA, Ruckdeschel JC, Wagner H Jr, Stevens CW: Treatment of non-small cell lung cancer-stage IIIA: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007, 132(3 Suppl):243S-265S.
- [6]Summary of the Product Characteristics (Vinorelbine). 2012.
- [7]Jensen LH, Osterlind K, Rytter C: Randomized cross-over study of patient preference for oral or intravenous vinorelbine in combination with carboplatin in the treatment of advanced NSCLC. Lung Cancer 2008, 62(1):85-91.
- [8]Tan EH, Rolski J, Grodzki T, Schneider CP, Gatzemeier U, Zatloukal P, Aitini E, Carteni G, Riska H, Tsai YH, Abratt R: Global Lung Oncology Branch trial 3 (GLOB3): final results of a randomised multinational phase III study alternating oral and i.v. vinorelbine plus cisplatin versus docetaxel plus cisplatin as first-line treatment of advanced non-small-cell lung cancer. Ann Oncol 2009, 20(7):1249-1256.
- [9]Vokes EE, Herndon JE 2nd, Crawford J, Leopold KA, Neill H, Perry MC, Miller AA, Green MR: Randomized phase II study of cisplatin with gemcitabine or paclitaxel or vinorelbine as induction chemotherapy followed by concomitant chemoradiotherapy for stage IIIB non-small-cell lung cancer: cancer and leukemia group B study 9431. J Clin Oncol 2002, 20(20):4191-4198.
- [10]Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG: New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000, 92(3):205-216.
- [11]Fleming TR: One-sample multiple testing procedure for phase II clinical trials. Biometrics 1982, 38(1):143-151.
- [12]Roswit B, Patno ME, Rapp R, Veinbergs A, Feder B, Stuhlbarg J, Reid CB: The survival of patients with inoperable lung cancer: a large-scale randomized study of radiation therapy versus placebo. Radiology 1968, 90(4):688-697.
- [13]Rolland E, Le Chevalier T, Auperin A, Burdett S, Pignon JP: Sequential radio-chemotherapy (RT-CT) versus radiotherapy alone (RT) and concomitant RT-CT versus RT alone in locally advanced NSCLC: two meta-analyses using individual patient data (IPD) from randomised clinical trials (RCTs). J Thorac Oncol 2007, 2(Suppl 8):309-310.
- [14]Le Chevalier T, Arriagada R, Quoix E, Ruffie P, Martin M, Tarayre M, Lacombe-Terrier MJ, Douillard JY, Laplanche A: Radiotherapy alone versus combined chemotherapy and radiotherapy in nonresectable non-small-cell lung cancer: first analysis of a randomized trial in 353 patients. J Natl Cancer Inst 1991, 83(6):417-423.
- [15]Furuse K, Fukuoka M, Kawahara M, Nishikawa H, Takada Y, Kudoh S, Katagami N, Ariyoshi Y: Phase III study of concurrent versus sequential thoracic radiotherapy in combination with mitomycin, vindesine, and cisplatin in unresectable stage III non-small-cell lung cancer. J Clin Oncol 1999, 17(9):2692-2699.
- [16]Auperin A, Le Pechoux C, Rolland E, Curran WJ, Furuse K, Fournel P, Belderbos J, Clamon G, Ulutin HC, Paulus R, Yamanaka T, Bozonnat MC, Uitterhoeve A, Wang X, Stewart L, Arriagada R, Burdett S, Pignon JP: Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol 2010, 28(13):2181-2190.
- [17]Fournel P, Robinet G, Thomas P, Souquet PJ, Lena H, Vergnenegre A, Delhoume JY, Le Treut J, Silvani JA, Dansin E, Bozonnat MC, Daurés JP, Mornex F, Pérol M: Randomized phase III trial of sequential chemoradiotherapy compared with concurrent chemoradiotherapy in locally advanced non-small-cell lung cancer: Groupe Lyon-Saint-Etienne d’Oncologie Thoracique-Groupe Francais de Pneumo-Cancerologie NPC 95–01 Study. J Clin Oncol 2005, 23(25):5910-5917.
- [18]Vergnenegre A, Daniel C, Lena H, Fournel P, Kleisbauer JP, Le Caer H, Letreut J, Paillotin D, Perol M, Bouchaert E, Preux PM, Robinet G: Docetaxel and concurrent radiotherapy after two cycles of induction chemotherapy with cisplatin and vinorelbine in patients with locally advanced non-small-cell lung cancer. A phase II trial conducted by the Groupe Francais de Pneumo-Cancerologie (GFPC). Lung Cancer 2005, 47(3):395-404.
- [19]Horinouchi H, Sekine I, Sumi M, Noda K, Goto K, Mori K, Tamura T: Long term results of concurrent chemoradiotherapy using cisplatin and vinorelbine for stage III non-small-cell lung cancer. Cancer Sci 2013, 104:93-97.
- [20]Krzakowski M, Provencio M, Utracka-Hutka B, Villa E, Codes M, Kuten A, Henke M, Lopez M, Bell D, Biti G, Caux NR, Pouget JC, Dubray B, David P: Oral vinorelbine and cisplatin as induction chemotherapy and concomitant chemo-radiotherapy in stage III non-small cell lung cancer: final results of an international phase II trial. J Thorac Oncol 2008, 3(9):994-1002.
- [21]Descourt R, Vergnenegre A, Barlesi F, Lena H, Fournel P, Falchero L, Berard H, Hureaux J, Le Caer H, Chavaillon JM, Geriniere L, Monnet I, Chouabe S, Robinet G: Oral vinorelbine and cisplatin with concurrent radiotherapy after induction chemotherapy with cisplatin and docetaxel for patients with locally advanced non-small cell lung cancer: the GFPC 05–03 study. J Thorac Oncol 2011, 6(2):351-357.
- [22]Hanna N, Neubauer M, Yiannoutsos C, McGarry R, Arseneau J, Ansari R, Reynolds C, Govindan R, Melnyk A, Fisher W, Richards D, Bruetman D, Anderson T, Chowhan N, Nattam S, Mantravadi P, Johnson C, Breen T, White A, Einhorn L: Phase III study of cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel in patients with inoperable stage III non-small-cell lung cancer: the Hoosier Oncology Group and U.S. Oncology. J Clin Oncol 2008, 26(35):5755-5760.
- [23]Kelly K, Chansky K, Gaspar LE, Albain KS, Jett J, Ung YC, Lau DH, Crowley JJ, Gandara DR: Phase III trial of maintenance gefitinib or placebo after concurrent chemoradiotherapy and docetaxel consolidation in inoperable stage III non-small-cell lung cancer: SWOG S0023. J Clin Oncol 2008, 26(15):2450-2456.