비소세포 폐암 환자의 2차 치료로서 Gemcitabine과 Vinorelbine의 병합 요법의 효과
Phase Ⅱ Study of Gemcitabine and Vinorelbine as a Combination Chemotherapy for the Second-Line Treatment of Nonsmall Cell Lung Carcinoma
이승룡 (고려대학교)
신철 (고려대학교)
심재정 (고려대학교)
인광호 (고려대학교)
김제형 (고려대학교)
이상엽 (고려대학교)
강경호 (고려대학교)
유세화 (고려대학교)
하은실 (고려대학교)
박상훈 (고려대학교)
허규영 (고려대학교)
정기환 (고려대학교)
정혜철 (고려대학교)
- 다운로드 수
- 조회수
초록
배 경 :새로운 항암제의 사용으로 비소세포 폐암에서 1차 항암 치료의 효과는 많이 향상 되었지만 많은 환자에서 치료 중 혹은 치료 후에 폐암이 진행하거나 재발되고 있다. 최근 환자의 체력 및 영양 상태의 향상으로 폐암의 진행 및 재발 후에도 신체 수행 상태(performance status)가 양호하여 2차 항암 치료의 대상 환자가 늘어나는 추세이다. 그러나 아직까지 표준화된 2차 항암 치료가 없는 실정으로 gemcitabine과 vinorelbine의 병합 요법은 비교적 다른 기전의 독성을 보여 병합 요법으로서의 가능성을 높여 주었다. 이에 저자들은 1차 항암 요법에 반응을 보이지 않거나 재발한 진행성 비소세포 폐암 환자를 대상으로 gemcitabine 과 vinorelbine 병합 요법을 시행하여 치료 반응율, 생존율 및 독성에 대해 연구하였다.대상 및 방법 : 2000년 12월부터 2003년 7월까지 고려대학교 의료원에 내원하여 비소세포 폐암으로 확진 받은 환자 중 진단 당시 IIIB, IV병기로 platinum을 기반으로 docetaxel 혹은 paclitaxel의 2제 복합 항암 요법을 1차 치료로 시행한 환자 중 진행하거나 재발한 환자들을 대상으로 gemcitabine과 vinorelbine 병합 요법의 치료 반응율, 생존율 및 독성을 분석하였다.
- keywords
- Nonsmall cell lung cancer, Gemcitabine, Vinorelbine, Phase II study, Nonsmall cell lung cancer, Gemcitabine, Vinorelbine, Phase II study
Abstract
Backgroud : Lung cancer is the leading cause of cancer deaths in Korea and the number of lung cancer deaths is increasing. The higher response rates, decreased toxicity and improved performance status of the first-line treatments have resulted in an increased number of patients becoming candidates for second-line therapy. Several new antineoplastic agents, including gemcitabine, docetaxel and paclitaxel, have recently demonstrated second-line activity. This phase II study evaluated the efficacy and toxicity of gemcitabine and vinorelbine as combination chemotherapy for Korean patients with NSCLC as a second-line treatment. Methods : Sixty response-evaluable patients were enrolled from December 2000 to July 2003. We conducted a phase II study of a combination gemcitabine and vinorelbine chemotherapy for patients with histologically confirmed NSCLC that was stage IIIB and IV disease at the time of diagnosis, and the disease had progressed onward or the patients had relapsed after first-line platinum-based chemotherapy. They were treated with intravenous gemcitabine 1000mg/m2 and intravenous vinorelbine 25mg/m2 on days 1 and 8. This chemotherapy regimen was repeated every 3 weeks. Results : A total of 215 cycles of treatment were given and the mean number of cycles was 3.6 cycles. All the patients were evaluable for the toxicity profile. The response rate was 10% according to the WHO criteria. The median progression free survival was 3.8 months and the median survival time was 10.1 months. The 1-year survival rate was 32.9%. Grade III and IV neutropenia were seen in 20 (33.3%) and 7 (11.7%) patients, respectively. Conclusion : The combination of gemcitabine and vinorelbine is active and well tolerated as a second-line therapy for patients with advanced nonsmall cell lung carcinoma. (Tuberc Respir Dis 2005; 59: 510-516)
- keywords
- Nonsmall cell lung cancer, Gemcitabine, Vinorelbine, Phase II study, Nonsmall cell lung cancer, Gemcitabine, Vinorelbine, Phase II study
참고문헌
(2004) The result of cause of death in 2003, Korea National Statistical office
(2002) Comparison of four chemotherapy regimens for advanced non-small cell lung cancer,
(2004) Second-line chemotherapy for non-small- cell lung cancer:recent data with pemetrexed,
(2004) Therapeutic advances in second-line treatment of advanced non-small-cell lung cancer,
(2004) Second-line chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC),
(2005) The current situation:erlotinib and gefitinib in non-small cell lung cancer,
(1996) Vinorebine:an overview,
(1991) A phase II study of vinorelbine in the treatment of non-small cell lung cancer,
(1994) A phase II study of vinorelbine,a new derivative of vinca alkaloid,for previously untrated advanced non-small cell lung cancer,
(1997) Modified weekly regimen with vinorelbine as a single agent in unresectable non- small cell lung cancer,
(2002) The novel and effective nonplatinum,nontaxane combination of gemcitabine and vinorelbine in advanced nonsmall cell lung carcinoma,
(2000) Phase III trial of gemcitabine plus cisplatin versus cisplatin alone in patients with locally advanced or metastatic non- small cell lung cancer,
(1994) Efficacy and safety profile of gemcitabine in non-small cell lung cancer:a phase II study,
(1997) Cisplatin-gemcitabine combination in advanced non-small cell lung cance:a phase II study,
(2001) Gemcitabine and vinorelbine as first-line therapy for non-small cell lung cancer:a phase II trial,
(1995) Phase II trials of single-agent activity of gemcitabine in patients with advanced non-small cell lung cancer:an overview,
(1997) Vinorelbine is well tolerated and active in the treatment of elderly patients with advanced non-small cell lung cancer:a two stage phage II study,
(2000) Gemcitabine and vinorelbine in the second-line treatment of non-small cell lung carcinomas patients,
(2000) Second-line treatment with gemcitabine and vinorelbine in non-small cell lung cancer cisplatin failures: a pilot study.,
(2001) Gemcitabine and vinorelbine as second-line therapy in non-small cell lung cancer after prior treatment with taxene+platinum-based regimens,
(2001) An out-patient second-line chemotherapy with gemcitabine and vinorelbine in patients with non-small cell lung cancer previously treated with platinum-based chemotherapy:a phase II study of the Hellenic co-operative oncology group,
(2005) Gemcitabine plus vinorelbine as second-line chemotherapy of the patients of previously treated non-small cell lung cancer,
(2004) Gemcitabine and vinorelbine as second-line therapy for non- small cell lung cancer after treatment with paclitaxel plus platinum,
(2001) Comparision of docetaxel/cisplatin to docetaxel/gemcitabine as first-line treatment of advanced non-small cell lung cancer:early results of a randomized trial,
(2001) Challenging the platinum combinations:docetaxel combined with gemcitabine or vinorelbine in non-small cell lung caner,
(2000) Interim results of a Phase III trial.Paclitaxel/carboplatin vs paclitaxel/gemcitabine in advanced non-small cell lung cancer,
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수