P2-196: Combined modality treatment using a non-platinum-containing regimen and concurrent radiotherapy in the treatment of locally-advanced non-small cell lung cancer
Journal of Thoracic Oncology
In the era of targeted agents, combined chemoradiotherapy remains standard of care for non-resectable stage III non-small cell lung cancer (NSCLC). While recognizing that we have probably reached a plateau in terms of treatment results using this strategy, it is still imperative to reduce toxicities while not compromising efficacy. This study aims to evaluate a non-platinum-containing regimen used in conjunction with radiotherapy. Methods: Patients with histologically proven, non-resectable
... e III NSCLC are eligible for the study. They must be above 18 years old, have good performance status, and have adequate bone marrow, renal and hepatic function. Patients will receive 2 cycles of induction vinorelbine (25mg/m 2 ) and gemcitabine (1000mg/m 2 ) given on days 1 and 8 every 21 days, followed by radiotherapy 60-66Gy with concurrent weekly vinorelbine (15mg/m 2 ). The primary objective is to assess the response rate to this regimen and secondary objectives to assess tolerability and toxicity. Results: We have completed the target accrual of 42 patients. There are 31 males and 11 females. The median age is 65, range of 41 to 79. Sixty-one percent has stage IIIB disease and 38.9% has stage IIIA disease. Forty-four percent of the patients have adenocarcinoma and 25% of patients have squamous cell carcinoma. Fifteen patients (36%) achieved a partial response after induction chemotherapy. After chemoradiotherapy, 7 patients had complete response and 19 patients had partial response, giving an overall response rate of 62%. Toxicity data is available for 36 patients. Nine patients(25%) had grade 3 or 4 neutropenia, 4 patients(11%) had grade 3 esophagitis and 3 patients(8%) had grade 3 fatigue. Conclusion: The toxicities of this regimen are low and the response rate is comparable to similar treatment schedules with platinum-based chemotherapy. Background: concurrent chemoradiotherapy treatment is standard of care for patients with stage III NSCLC and a good performance status.