Modified 3-week schedule of gemcitabine plus cisplatin for non-small cell lung cancer treatment

Purpose: Gemcitabine-cisplatin combination is one of the most used schedules for non small cell lung cancer (NSCLC). Aiming to enhance dose intensity and reduce toxicity, the original 4-week schedule was modified or transformed into a 3-week schedule. The purpose of this study was to report the efficacy and tolerability of a modified 3-week regimen of gemcitabine-cisplatin. Methods: Our patients were treated with gemcitabine (1000 mg/m²) on days 1, 8 and cisplatin on day 8 (75-100 mg/m²). The toxicity was recorded according to the NCIC criteria. Results: From October 2000 to December 2009 a consecutive series of 196 patients with a median age of 62 years and III-IV stage NSCLC received gemcitabine-cisplatin as induction therapy (76 patients) or palliative treatment (120 patients). The median dose intensity was 89%. In relation to day 8 of chemotherapy, 16.2% of the treatments were delayed due to hematologic toxicities. Grade 3-4 anaemia, neutropenia and thrombocytopenia was reported in 3.5, 43.8 and 4.6%, respectively. Response rate (RR) and median overall survival (OS) were 74% and 11 months in patients with locally advanced disease, and 46.7% and 9 months in metastatic patients, respectively. Conclusions: In comparison with standard or modified schedules of literature, our modified 3-week regimen of gemcitabine-cisplatin demonstrated to be equally active, similar for dose intensity and well tolerated, with better hematologic toxicity profile in terms of anaemia and thrombocytopenia.