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Japanese Journal of Clinical Oncology Advance Access originally published online on September 25, 2009
Japanese Journal of Clinical Oncology 2009 39(12):779-783; doi:10.1093/jjco/hyp111
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© The Author (2009). Published by Oxford University Press. All rights reserved

Phase II Trial of Weekly Gemcitabine and Split-dose Cisplatin for Advanced Non-small-cell Lung Cancer

Atsushi Hiramatsu, Yoshinobu Iwasaki, Yasunori Koyama, Nobuyo Tamiya, Shigekuni Hosogi, Masaki Nakanishi, Yoshihito Kohno, Mikio Ueda, Taichiro Arimoto and Yoshinori Marunaka

Division of Pulmonary Medicine, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

For reprints and all correspondence: Yoshinobu Iwasaki, Division of Pulmonary Medicine, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602, Japan. E-mail: yiwasaki{at}koto.kpu-m.ac.jp

Received April 3, 2009; accepted August 8, 2009

Objective: Cisplatin is widely used for the treatment of non-small-cell lung cancer. However, it can cause unpleasant side effects and also requires prolonged hydration. We conducted a Phase II study of weekly gemcitabine and split-dose cisplatin in patients with advanced non-small-cell lung cancer (NSCLC) in order to reduce toxicity and shorten the time taken by administration. Our aims were to determine the response rate, toxicity and survival time with this regimen in patients with Stage IIIB/IV disease.

Methods: Previously untreated patients with Stage IIIB/IV NSCLC were given gemcitabine (1000 mg/m2) and split-dose cisplatin (40 mg/m2) on days 1 and 8 at 3-week intervals for four cycles. Gemcitabine was administered over the course of 30 min, and cisplatin was over the course of 60 min on the same days on an outpatient basis.

Results: Forty-five patients were enrolled, and all of them were assessable for response and toxicity. None had a complete response and 17 had a partial response (37.8%), for an overall response rate of 37.8% (95% confidence interval, 25.1–52.4%). The survival rate was 56.5% at 1 year and 38.9% at 2 years, with a median survival time of 15.7 months. Leukopenia, neutropenia, anemia and thrombocytopenia were the most common toxic reactions, with Grade ≥ 3 reactions occurring at rates of 35%, 51%, 31% and 13%, respectively.

Conclusions: Weekly gemcitabine and split-dose cisplatin is active and well tolerated in patients with Stage IIIB/IV NSCLC, administered on an outpatient basis without requiring prolonged hydration or hospitalization.

Key Words: non-small-cell lung cancer • weekly • split-dose • cisplatin • gemcitabine


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