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- 저자 : Biesma, Bonne (검색결과 1 건)
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Scagliotti, Giorgio Vittorio,Parikh, Purvish,von Pawel, Joachim,Biesma, Bonne,Vansteenkiste, Johan,Manegold, Christian,Serwatowski, Piotr,Gatzemeier, Ulrich,Digumarti, Raghunadharao,Zukin, Mauro,Lee, American Society of Clinical Oncology 2008 Journal of clinical oncology Vol.26 No.21
<B>Purpose</B><P>Cisplatin plus gemcitabine is a standard regimen for first-line treatment of advanced non-small-cell lung cancer (NSCLC). Phase II studies of pemetrexed plus platinum compounds have also shown activity in this setting.</P><B>Patients and Methods</B><P>This noninferiority, phase III, randomized study compared the overall survival between treatment arms using a fixed margin method (hazard ratio [HR] < 1.176) in 1,725 chemotherapy-naive patients with stage IIIB or IV NSCLC and an Eastern Cooperative Oncology Group performance status of 0 to 1. Patients received cisplatin 75 mg/m<SUP>2</SUP>on day 1 and gemcitabine 1,250 mg/m<SUP>2</SUP>on days 1 and 8 (n = 863) or cisplatin 75 mg/m<SUP>2</SUP>and pemetrexed 500 mg/m<SUP>2</SUP>on day 1 (n = 862) every 3 weeks for up to six cycles.</P><B>Results</B><P>Overall survival for cisplatin/pemetrexed was noninferior to cisplatin/gemcitabine (median survival, 10.3 v 10.3 months, respectively; HR = 0.94; 95% CI, 0.84 to 1.05). Overall survival was statistically superior for cisplatin/pemetrexed versus cisplatin/gemcitabine in patients with adenocarcinoma (n = 847; 12.6 v 10.9 months, respectively) and large-cell carcinoma histology (n = 153; 10.4 v 6.7 months, respectively). In contrast, in patients with squamous cell histology, there was a significant improvement in survival with cisplatin/gemcitabine versus cisplatin/pemetrexed (n = 473; 10.8 v 9.4 months, respectively). For cisplatin/pemetrexed, rates of grade 3 or 4 neutropenia, anemia, and thrombocytopenia (P ≤ .001); febrile neutropenia (P = .002); and alopecia (P < .001) were significantly lower, whereas grade 3 or 4 nausea (P = .004) was more common.</P><B>Conclusion</B><P>In advanced NSCLC, cisplatin/pemetrexed provides similar efficacy with better tolerability and more convenient administration than cisplatin/gemcitabine. This is the first prospective phase III study in NSCLC to show survival differences based on histologic type.</P>
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