A combination of Gemzar® (gemcitabine) and Paraplatin® (carboplatin) is as effective as standard Platinol® (cisplatin) and VePesid® (etoposide) for palliative treatment of patients with poor-risk small cell lung cancer (SCLC). The Gemzar/Paraplatin combination is also less toxic, according to the results of a study published in an early online publication of Thorax on September 11, 2008.
Small cell lung cancer accounts for approximately 10-15% of all lung cancers. SCLC is a very fast growing type of lung cancer, often spreading quickly to distant sites in the body. The standard regimen for treating patients with SCLC is Platinol and VePesid; however, research is ongoing in order to establish regimens that are potentially more effective and/or less toxic.
A multicenter clinical trial in the United Kingdom involved 241 patients with untreated, extensive SCLC who were randomly assigned to receive six, three-weekly cycles of either Gemzar and Paraplatin or Platinol and VePesid. The results indicated that the two regimens provided equivalent results: median survival was eight months in the Gemzar/Paraplatin group and 8.1 months in the Platinol/VePesid group; median progression-free survival was 5.9 months in the Gemzar/Paraplatin group and 6.3 months in the Platinol/VePesid group.
Although the outcomes from both regimens appeared to be equivalent, the group of patients receiving Gemzar/Paraplatin reported a higher quality of life. Nausea and hair loss were more frequent in the Platinol/VePesid group. Although grade 3-4 myelosuppresion (low blood counts) was more frequent in the Gemzar/Paraplatin group, it was not associated with increased hospital admissions, infections, or fatalities. Patients in the Gemzar/Paraplatin group received more chemotherapy as outpatients (89% versus 66% in the Platinol/VePesid group.) In quality-of-life questionnaires, more patients in the Platinol/VePesid group reported being upset by hair loss and impaired cognitive functioning.
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These authors concluded, “Gemzar/Paraplatin is as effective as Platinol/VePesid in terms of overall survival and progression-free survival, and has a toxicity profile more acceptable to patients.”
 Lee SM, James L, Qian W, et al. Comparison of gemcitabine and carboplatin versus cisplatin and etoposide for patients with poor-prognosis small cell lung cancer. Thorax [early online publication]. September 11, 2008.
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