New drug combinations improve treatment for advanced lung cancer

May 15, 1999

A phase-II study testing three drug combinations found that all three were more effective than standard therapy for treatment of stage-3 non-small-cell lung cancer. Median survival for patients receiving standard therapy--two cycles of cisplatin and vinblastine followed by radiation therapy--is about 14 months. The new drug combinations added about four months to the median, raising it to 18 months.

"Each of the three drug combinations produced a modest and quite similar improvement in survival times," said Everett Vokes, MD, professor of medicine and section chief of hematology/oncology at the University of Chicago and director of the study. "They may also have produced more long-term survivors, but it is still too soon to be certain."

The multi-center study, coordinated by Cancer and Leukemia Group B and presented May 15, 1999 at the annual meeting of the American Society of Clinical Oncology, followed 180 patients with stage 3B lung cancers that were not treatable with surgery. Patients received four cycles of cisplatin in combination with either gemcitibine, paclitaxel or vinorelbine. They also received radiation therapy during the last two cycles.

Side effects of all three treatments, which included reduced white-blood-cell and platelet counts, were similar. Although gemcitibine provided slightly better local control, it also produced more toxicity when combined with radiation.

"These drugs have demonstrated their value in the patients with even more advanced disease, those with stage-4 cancers," said Vokes. "This is the first trial to assess their risks and benefits in patients where there is the potential for cure."

Since the trial was just completed last August, it's too soon to determine how many patients will remain disease-free for the long term, but "extending the median survival time is a good early marker," said Vokes.