Chemotherapy in Advanced Non-Small Cell Lung Cancer. Changes in Performance Status and Tumour-Related Symptoms

Thatcher, Nick; Ranson, Malcolm R; Anderson, Heather

doi:10.1007/978-3-642-79200-7_9

Cited by 2 publications

(1 citation statement)

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“…15 , one large randomized prospective study failed to show any significant antitumor activity with vindesine alone in patients with advanced NSCLC 14 . It is therefore unlikely that these agents, although poorly toxic, will play a significant role in the medical treatment of NSCLC in older patients. Although the real impact of chemotherapy on the survival of NSCLC patients is still the subject of debate, evidence is accumulating of a chemotherapyrelated clinical benefit in terms of improvement of symptoms and performance status 21 • Therefore a chemotherapy challenge in symptomatic patients with…”

Section: Discussionmentioning

confidence: 99%

The Role of Vindesine and Lonidamine in the Treatment of Elderly Patients with Advanced Non-small Cell Lung Cancer: A Phase III Randomized Fonicap Trial

Marinis

Rinaldi

Ardizzoni

et al. 1999

Tumori

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Aims To evaluate the efficacy and treatment compliance in elderly patients with advanced non-small cell lung cancer (NSCLC) of two chemotherapeutic agents with mild toxicity, 153 previously untreated patients aged over 70 years were randomized to receive lonidamine (450 mg daily p.o. until progression), vindesine (3 mg/m2/daily i.v. weekly for 4 weeks and then every 2 weeks until progression), the combination of the two drugs at the same dose and schedule, or supportive therapy only in a four-arm factorial randomized trial. Methods 126 patients were included in the final analysis. Their median age was 75 years. Forty percent had stage IV disease and 60% stage III. Most patients were males (85%) and the majority had squamous histology (68%). Results Among 104 patients evaluable for response there were only 3 PRs (1/30 in the lonidamine arm and 2/33 in the lonidamine + vindesine arm). Overall, 8.7% and 9.5% of the patients, respectively, progressed or died early, before response evaluation; another 9.4% refused treatment continuation because of poor compliance with the study protocol. Eighty-five patients were fully evaluable for toxicity, which was generally mild. Leukopenia grade 1-3 was found in less than 30% of patients treated with vindesine or vindesine + lonidamine. The most common complaints associated with lonidamine treatment were myalgia (70% of patients), fatigue (55% and 83% of patients treated with lonidamine or lonidamine + vindesine, respectively) and testicular pain in nearly 40% of cases. The overall median survival was 170 days, with no significant impact on survival of either lonidamine or vindesine. Conclusions The low response rate and survival together with the poor treatment compliance, even in the presence of mild toxicity, do not support the usefulness of these “gentle” chemotherapies in elderly NSCLC patients. The standard management of advanced NSCLC in elderly patients remains to be defined. Specifically designed studies to address this issue are warranted.

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Section: Discussionmentioning

confidence: 99%