Chemotherapy Regimens for Non SmallCell Lung Cancer

Surgery and radiotherapy remain the best treatment options for resectable non-small-cell lung cancer (NSCLC). The role of adjuvant chemotherapy in successfully resected NSCLC is still highly controversial. Whereas the largest trial (IALT, International Adjuvant Lung Cancer Trial) (see Tona-to 2002) showed a small but significant survival benefit for patients treated with cisplatin-based chemotherapy, the Italian trial (ALPI) (see Alexa-nian and Torri 2000) and the UK trial (Big Lung Trial) (see Evans 2004) did not show any significant differences.

In patients with unresectable tumors combination chemotherapy is the cornerstone of treatment. Patients with a good performance status benefit more from the combination therapy than patients with a poor condition. New drugs have been evaluated (taxanes, gemcitabine, vinorelbine). Up to now there is no standard therapy regimen, but therapies should be platinum based. Tables 20-23 show combination chemotherapy regimens frequently used for the treatment of NSCLC.

Table 20. Cisplatin/gemcitabine (Schiller 2000)

Cisplatin

100 mg/m2

i.v.

Day 1

Gemcitabine

1000 mg/m2

i.v.

Days 1, 8, 15

Every 4 weeks

Every 4 weeks

Table 21. One example of a new chemotherapy regimen developed for NSCLC and so far applied only under study conditions: carboplatin + paclitaxel

Paclitaxel 225 mg/m2

i.v.

Day 1

Carboplatin AUC 6

i.v.

Day 1

Repetition from day 28

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