According to a recent article published in the Journal of Clinical Oncology, the addition of the chemotherapy agent Gemzar (gemcitabine) to the commonly used chemotherapy regimen paclitaxel (Taxol®) plus carboplatin (Paraplatin®) appears to improve survival for patients with advanced non-small cell lung cancer.

Lung cancer remains the leading cause of cancer-associated deaths in the U.S. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, comprising approximately 80% of all lung cancers. NSCLC is named for the type of cell within the lung where the cancer originated.

In advanced lung cancer, cancer has spread from the lung to distant sites in the body. Chemotherapy remains the cornerstone of treatment for advanced NSCLC. Long-term survival, however, remains dismal for patients with this disease. Researchers continue to evaluate novel therapeutic options, including different chemotherapy combinations.

Paclitaxel plus carboplatin is one of the most commonly used chemotherapy regimens in the treatment of NSCLC in the U.S. and Europe. Gemzar is currently approved for use with cisplatin (Platinol®) as initial therapy in advanced NSCLC, as well as treatment of pancreatic cancer and in combination with pactlixel for the treatment of recurrent, advanced breast cancer.

Researchers from Italy recently conducted a clinical trial to compare a standard chemotherapy regimen consisting of paclitaxel plus carboplatin to Gemzar/paclitaxel/carboplatin in the treatments stages IIIB or IV NSCLC. Patients had not received prior chemotherapy, and those with stage IIIB NSCLC were not suitable for aggressive radiation therapy.

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The trial included 324 patients; approximately half were treated with paclitaxel/carboplatin (PC) and the other half received Gemzar/paclitaxel/carboplatin (PCG).

Patients treated with PCG had improved outcomes compared to those treated with PC:

  • Overall anticancer responses occurred in nearly half of the patients (46%) treated with PCG, versus only 20% for those treated with PC.
  • Median time to cancer progression was 7.6 months for patients treated with PCG, compared with only 5.1 months for those treated with PC.
  • Median overall survival was nearly 11 months (10.8 months) for patients treated with PCG, compared to 8.3 months for those treated with PC.
  • Survival at one year was 45% for patients treated with PCG, compared with 34% for those treated with PC.
  • The side effects associated with the addition of Gemzar to PC were low immune cell levels, low platelet levels, and low red blood cell levels.

The researchers concluded that the addition of Gemzar to paclitaxel/carboplatin appears to significantly improve outcomes, including survival, compared to PC alone. As well, the addition of Gemzar to PC was generally well tolerated.

Reference: Paccagnella A, Oniga F, Bearz A, et al. Adding Gemcitabine to Paclitaxel/Carboplatin Combination Increases Survival in Advanced Non–Small-Cell Lung Cancer: Results of a Phase II-III Study. Journal of Clinical Oncology. 2006; 24: 681-687.

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