Recently the British Journal of Cancer reported the results of a study that assessed the efficacy of combination chemotherapy vs. single agent chemotherapy in the treatment of elderly or unfit individuals diagnosed with non-small cell lung cancer (NSCLC). Combinations of chemotherapy including Gemzar®(gemcitabine) plus paclitaxel (Taxol®) or vinorelbine were compared with chemotherapy consisting of paclitaxel or Gemzar® alone.
Lung cancer is the leading cause of cancer related deaths in the United States and Europe. The most common type of lung cancer, non-small cell lung cancer, is a malignancy which arises from the tissues of the lung. Under most circumstances NSCLC is not curable. Current treatments include surgery, chemotherapy and radiation in an attempt to destroy tumor cells or prevent further tumor growth. These treatments may extend over a period of weeks to months and are often associated with side effects, which may be particularly difficult to tolerate for the elderly or patients with other medical conditions.
In this study, a total of 264 NSCLC patients who were 70 years of age or older, or who were younger but were medically determined to be physically unfit for treatment, were assigned to be treated with one of the following regimens: Gemzar® or paclitaxel weekly for 3 weeks, followed by a week of rest; Gemzar® plus paclitaxel weekly for 2 weeks every 3 weeks; or Gemzar® plus vinorelbine weekly for 2 weeks every 3 weeks. Overall, one-year survival for Gemzar® alone was 29% and for paclitaxel alone was 25%. For patients treated with combination chemotherapy, one-year survival rates were 44% for patients treated with Gemzar® and paclitaxel and 32% for patients treated with Gemzar® and vinorelbine. Further analysis showed that patients who were treated with combination chemotherapy and who were in better physical condition ultimately had a longer survival time. Side effects were no more toxic with combination chemotherapy than with single agent chemotherapy.
Researchers conclude that chemotherapy with Gemzar® and paclitaxel should be a consideration for elderly patients diagnosed with NSCLC, provided that they are in fair to good medical condition. Patients may wish to speak to their physician regarding their treatment options.
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Reference: Gemcitabine with either paclitaxel or vinorelbine vs. paclitaxel or gemcitabine alone for elderly or unfit advanced non-small cell lung cancer patients. British Journal of Cancer. 2004; 91: 489-497.
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