Final Overall Results of a Study with a Novel Triplet Induction Chemotherapy Regimen (PACCAGE) Followed by Consolidation Radiotherapy in Locally Advanced Inoperable Non-small Cell Lung Cancer (NSCLC)

Schallier, Denis; Bral, Samuel; Ilsen, Bart; Neyns, Bart; Fontaine, Christel; Decoster, Lore; Mey, Johan De; Meysman, Marc; Grève, Jacques De

doi:10.1097/jto.0b013e3181a4ec14

Cited by 11 publications

(11 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the study by Schallier et al ., with 64 patients constituting the study population, 55% PR was obtained after three cycles of triplet induction chemotherapy regimen of paclitaxel, carboplatin and gemcitabine (PACCAGE). 19 In the study by Hirsh et al . of 41 assessable patients who were treated with induction two cycles of carboplatin and gemcitabine 73.1% achieved PR and 24.4% SD.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, there were several attempts to improve results of treatment locally advanced NSCLC. Trials with concurrent radiochemotherapy in combination with induction or consolidation chemotherapy using platinum-based combinations report median survival in the range of 13 to 29.5 months 19 – 23 , 26 – 29 , 3-year survival in the range of 13% to 39.8% 22 , 27 and 5-year survival in the range of 12.5% to 22%. 19 , 26 , 29 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Induction Gemcitabine in Standard Dose or Prolonged Low-Dose with Cisplatin Followed By Concurrent Radiochemotherapy in Locally Advanced Non-Small Cell Lung Cancer: a Randomized Phase Ii Clinical Trial

2014

View full text Add to dashboard Cite

Background The optimal combination of chemotherapy with radiation therapy for treatment locally advanced non-small cell lung cancer (NSCLC) remains an open issue. This randomized phase II study compared gemcitabine in two different schedules and cisplatin - as induction chemotherapy, followed by radiation therapy concurrent with cisplatin and etoposid. Patients and methods. Eligible patients had microscopically confirmed inoperable non-metastatic non-small cell lung cancer; fulfilled the standard criteria for platin-based chemotherapy; and signed informed consent. Patients were treated with 3 cycles of induction chemotherapy with gemcitabine and cisplatin. Two different aplications of gemcitabine were compared: patients in arm A received gemcitabine at 1250 mg/m 2 in a standard half hour i.v. infusion on days 1 and 8; patients in arm B received gemcitabine at 250 mg/m 2 in prolonged 6-hours i.v. infusion on days 1 and 8. In both arms, cisplatin 75 mg/m 2 on day 2 was administered. All patients continued treatment with radiation therapy with 60–66 Gy concurrent with cisplatin 50 mg/m 2 on days 1, 8, 29 and 36 and etoposid 50 mg/m 2 on days 1–5 and 29–33. The primary endpoint was response rate (RR) after induction chemotherapy; secondary endpoints were toxicity, progression-free survival (PFS) and overall survival (OS). Results From September 2005 to November 2010, 106 patients were recruited to this study. No statistically signifficant differences were found in RR after induction chemotherapy between the two arms (48.1% and 57.4%, p = 0.34). Toxicity profile was comparable and mild with grade 3/4 neutropenia as primary toxicity in both arms. One patient in arm B suffered from acute peripheral ischemia grade 4 and an amputation of lower limb was needed. With a median follow-up of 69.3 months, progression-free survival and median survival in arm A were 15.7 and 24.8 months compared to 18.9 and 28.6 months in arm B. The figures for 1- and 3-year overall survival were 73.1% and 30.8% in arm A, and 81.5 % and 44.4% in arm B, respectively. Conclusions Among the two cisplatin-based doublets of induction chemotherapy for inoperable NSCLC, both schedules of gemcitabine have a comparable toxicity profile. Figures for RR, PFS and OS are among the best reported in current literature. While there is a trend towards better efficacy of the treament with prolonged infusion of gemcitabine, the difference between the two arms did not reach statistical significance.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Induction Gemcitabine in Standard Dose or Prolonged Low-Dose with Cisplatin Followed By Concurrent Radiochemotherapy in Locally Advanced Non-Small Cell Lung Cancer: a Randomized Phase Ii Clinical Trial

2014

View full text Add to dashboard Cite

show abstract

“…Only one patient in arm B (1.9%) had progressive disease. In the study by Schallier et al ., with 64 patients constituting the study population, 55% PR was obtained after three cycles of triplet induction chemotherapy regimen of paclitaxel, carboplatin and gemcitabine (PACCAGE) 19. In the study by Hirsh et al .…”

Section: Discussionmentioning

confidence: 99%

“…Trials with concurrent radiochemotherapy in combination with induction or consolidation chemotherapy using platinum-based combinations report median survival in the range of 13 to 29.5 months19–23,26–29, 3-year survival in the range of 13% to 39.8%22,27 and 5-year survival in the range of 12.5% to 22% 19,26,29…”

Section: Discussionmentioning

confidence: 99%

Induction gemcitabine in standard dose or prolonged low-dose with cisplatin followed by concurrent radiochemotherapy in locally advanced non-small cell lung cancer: a randomized phase II clinical trial

Vrankar

Zwitter

Bavcar

et al. 2014

Radiology and Oncology

View full text Add to dashboard Cite

Disclosure: No potential conflicts of interest were disclosed.Background. The optimal combination of chemotherapy with radiation therapy for treatment locally advanced non-small cell lung cancer (NSCLC) remains an open issue. This randomized phase II study compared gemcitabine in two different schedules and cisplatin -as induction chemotherapy, followed by radiation therapy concurrent with cisplatin and etoposid.Patients and methods. Eligible patients had microscopically confirmed inoperable non-metastatic non-small cell lung cancer; fulfilled the standard criteria for platin-based chemotherapy; and signed informed consent. Patients were treated with 3 cycles of induction chemotherapy with gemcitabine and cisplatin. Two different aplications of gemcitabine were compared: patients in arm A received gemcitabine at 1250 mg/m 2 in a standard half hour i.v. infusion on days 1 and 8; patients in arm B received gemcitabine at 250 mg/m 2 in prolonged 6-hours i.v. infusion on days 1 and 8. In both arms, cisplatin 75 mg/m 2 on day 2 was administered. All patients continued treatment with radiation therapy with 60-66 Gy concurrent with cisplatin 50 mg/m 2 on days 1, 8, 29 and 36 and etoposid 50 mg/m 2 on days 1-5 and 29-33. The primary endpoint was response rate (RR) after induction chemotherapy; secondary endpoints were toxicity, progression-free survival (PFS) and overall survival (OS).Results. From September 2005 to November 2010, 106 patients were recruited to this study. No statistically signifficant differences were found in RR after induction chemotherapy between the two arms (48.1% and 57.4%, p = 0.34).Toxicity profile was comparable and mild with grade 3/4 neutropenia as primary toxicity in both arms. One patient in arm B suffered from acute peripheral ischemia grade 4 and an amputation of lower limb was needed. With a median follow-up of 69.3 months, progression-free survival and median survival in arm A were 15.7 and 24.8 months compared to 18.9 and 28.6 months in arm B. The figures for 1-and 3-year overall survival were 73.1% and 30.8% in arm A, and 81.5 % and 44.4% in arm B, respectively.Conclusions. Among the two cisplatin-based doublets of induction chemotherapy for inoperable NSCLC, both schedules of gemcitabine have a comparable toxicity profile. Figures for RR, PFS and OS are among the best reported in current literature. While there is a trend towards better efficacy of the treament with prolonged infusion of gemcitabine, the difference between the two arms did not reach statistical significance.

show abstract

“…Moreover, it can avoid the morbidity of fruitless CCRT for patients with poor tumor biology who underwent disease progression after induction chemotherapy. [ 22 – 24 ] With the mechanisms above, patients of locally advanced NSCLC could obtain better long-term survival in induction chemotherapy group than those who only treated by CCRT only. Marquez-Medina et al [ 25 ] reported that for patients treated by induction chemotherapy, the lower presence of angiolymphatic invasion and tumor necrosis were associated with a good survival.…”

Section: Discussionmentioning

confidence: 99%

The effect of induction chemotherapy in patients with locally advanced nonsmall cell lung cancer who received chemoradiotherapy

Luo

Liang

et al. 2017

Medicine

View full text Add to dashboard Cite

Background:The efficacy and toxicity of induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) in patients with locally advanced nonsmall cell lung cancer (NSCLC) is unclear, we performed a systematic review and meta-analysis of published papers to quantitatively evaluate the potential benefit of induction chemotherapy.Methods:Eligible studies of induction chemotherapy and chemoradiotherapy were retrieved through extensive searches of the PubMed, Science Direct, Embase, and Cochrane library databases from 1994 to 2015. We excluded studies that using non-English. Our primary endpoint was overall survival (OS), secondary end point was toxicity.Results:Two studies of induction chemotherapy followed by CCRT versus CCRT alone and 5 studies of induction chemotherapy followed by CCRT versus CCRT followed by consolidation chemotherapy published in the same period were selected and analyzed. Our results showed that there was significant benefit of induction chemotherapy plus CCRT compared to CCRT alone on 5-year OS without 1, 2, 3, and 4 years OS. Our analysis also indicated that induction chemotherapy was as effect as consolidation chemotherapy for patients who received CCRT on overall response and OS. Treatment-related toxicity was similar between the 2 group; however, leucopenia was significant decreased in patients treated by induction chemotherapy (odds ratio [OR] = 0.43; 95% confidence interval [CI], 0.30–0.62; P < 0.00001).Conclusion:Five year OS could be improved when induction chemotherapy was added into CCRT for patients of NSCLC. Except low rate of leucopenia, induction chemotherapy was no difference compared to consolidation chemotherapy in patients with NSCLC treated by CCRT.

show abstract

Final Overall Results of a Study with a Novel Triplet Induction Chemotherapy Regimen (PACCAGE) Followed by Consolidation Radiotherapy in Locally Advanced Inoperable Non-small Cell Lung Cancer (NSCLC)

Cited by 11 publications

References 29 publications

Induction Gemcitabine in Standard Dose or Prolonged Low-Dose with Cisplatin Followed By Concurrent Radiochemotherapy in Locally Advanced Non-Small Cell Lung Cancer: a Randomized Phase Ii Clinical Trial

Induction Gemcitabine in Standard Dose or Prolonged Low-Dose with Cisplatin Followed By Concurrent Radiochemotherapy in Locally Advanced Non-Small Cell Lung Cancer: a Randomized Phase Ii Clinical Trial

Induction gemcitabine in standard dose or prolonged low-dose with cisplatin followed by concurrent radiochemotherapy in locally advanced non-small cell lung cancer: a randomized phase II clinical trial

The effect of induction chemotherapy in patients with locally advanced nonsmall cell lung cancer who received chemoradiotherapy

Contact Info

Product

Resources

About