Gemcitabine hydrochloride (Gemzar®) is a chemotherapeutic drug that has unique activity against many solid tumors, including non-small cell lung cancer (NSCLC). Combination therapy with gemcitabine, cisplatin (Platinol®), and vinorelbine tartrate (Navelbine®) has been found to be safe and very active in persons with advanced non-small cell lung cancer (NSCLC). Tumors in these patients often cannot be removed by surgery (are unresectable), and so the patient may not survive for even 1 year without therapy.
| OPTION 1: Combination chemotherapy with gemcitabine (Gemzar®), cisplatin (Platinol®), and vinorelbine tartrate (Navelbine®) |
The toxic side effects of combination chemotherapy are manageable in most patients. Side effects include neutropenia (reduced number of granular white blood cells) and thrombocytopenia (reduced number of blood-clotting platelets).
Another treatment option for NSCLC patients with advanced disease is alternating chemo-radiotherapy (e.g., cisplatin and etoposide, followed by radiotherapy):
| OPTION 2: Combination chemotherapy with etoposide (VP-16, VePesid®) and cisplatin (Platinol®), also called "EC" followed by 60 Gy chest radiation therapy plus surgical resection of tumor or pneumonectomy (lung removal) in cases of operable tumor |
The toxic side effects of this program are leukopenia (reduced number of white blood cells) and vomiting.
Chemotherapeutic programs alone have limited activity against non-small cell lung cancer; however, new "protective" drugs, cytotoxic (cell-killing) agents, and radiotherapy techniques—either alone or in combination—are promising.
For example, the cell-protecting compound amifostine (Ethyol; Alza Pharmaceuticals, Palo Alto, CA/US Bioscience, West Conshohocken, PA) is being tested for its defense of normal tissue against the toxic effects of chemotherapy and radiotherapy. This, or similar medication(s), may permit physicians to use higher doses of chemotherapeutic agents (e.g., cisplatin, carboplatin, paclitaxel), thereby improving therapeutic results, prognosis, and survival.
Physician-developed and -monitored.
Original Date of Publication: 15 Aug 1999
Reviewed by: Stanley J. Swierzewski, III, M.D.
Last Reviewed: 04 Dec 2007
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