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Journal of Oncology
Volume 2009, Article ID 457418, 6 pages
Clinical Study

Non-Cross Resistant Sequential Single Agent Chemotherapy in First-Line Advanced Non-Small Cell Lung Cancer Patients: Results of a Phase II Study

1Department of Pulmonology, Erasmus MC-Daniel Den Hoed Cancer Center, Rotterdam, The Netherlands
2Department of Pulmonology, Amphia Hospital, Breda, The Netherlands
3Department of Pulmonology, St. Franciscus Gasthuis, Rotterdam, The Netherlands
4Department of Pulmonology, St. Antonius, Nieuwegein, The Netherlands
5Department of Trials and Statistics, Erasmus MC-Daniel Den Hoed Cancer Center, Rotterdam, The Netherlands

Received 17 April 2009; Revised 17 July 2009; Accepted 19 August 2009

Academic Editor: James L. Mulshine

Copyright © 2009 V. Surmont et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. sequential chemotherapy can maintain dose intensity and preclude cumulative toxicity by increasing drug diversity. Purpose. to investigate the toxicity and efficacy of the sequential regimen of gemcitabine followed by paclitaxel in first line advanced stage non-small cell lung cancer (NSCLC) patients with good performance status (PS). Patients and methods. gemcitabine 1250 mg/ m 2 was administered on day 1 and 8 of course 1 and 2; Paclitaxel 150 mg/ m 2 on day 1 and 8 of course 3 and 4. Primary endpoint was response rate (RR), secondary endpoints toxicity and time to progression (TTP). Results. Of the 21 patients (median age 56, range 38–80 years; 62% males, 38% females) 10% (2/21) had stage IIIB, 90% (19/21) stage IV, 15% PS 0, 85% PS 1. 20% of patients had a partial response, 30% stable disease, 50% progressive disease. Median TTP was 12 weeks (range 6–52 weeks), median overall survival (OS) 8 months (range 1–27 months), 1-year survival was 33%. One patient had grade 3 hematological toxicity, 2 patients a grade 3 peripheral neuropathy. Conclusions. sequential administration of gemcitabine followed by paclitaxel in first line treatment of advanced NSCLC had a favourable toxicity profile, a median TTP and OS comparable with other sequential trials and might , therefore, be a treatment option for NSCLC patients with high ERCC1 expression.