Cancer News       

Gemzar Plus Vinorelbine: A Well Tolerated Treatment Option for Elderly Patients with Advanced StageNon-Small Cell Lung Cancer

411 Cancer.com / Cancer Consultants

      Approximately 75% of persons who have lung cancer have a type of cancer referred to as non-small cell lung cancer (NSCLC). There are actually many different types of lung cancer that are considered to be NSCLC which are named according to the type of cell within the lung that the cancer originated. These include epidermoid or squamous carcinoma, adenocarcinoma, large cell carcinoma, adenosquamous carcinoma and undifferentiated carcinoma. 

     Treatment options depend on the stage, or extent of spread of the cancer in the body and may include surgery, chemotherapy, radiation and/or biologic therapy (treatment utilizing the patient's immune system to fight cancer). In stage IIIB NSCLC, the cancer has spread from the lungs to the chest wall, diaphragm (the breathing muscle between the chest and abdomen), and/or lymph nodes in the chest and neck. In stage IV, the cancer has spread from the lungs to distant parts of the body, many times including vital organs. Patients with stage IIIB or IV NSCLC are said to have advanced or metastatic disease. Elderly patients (70 years or older) with advanced stage NSCLC historically have not tolerated chemotherapy. It has been suggested that no treatment may be better than the toxic side effects incurred by chemotherapy. Often, the elderly have other illnesses or medical difficulties that exacerbate the side effects of chemotherapy treatment, making this option prohibitively risky. 

     Recently, studies involving two different chemotherapy drugs, Gemzar and vinorelbine have been evaluated separately in the treatment of elderly patients with NSCLC. Gemzar, when used alone as treatment, produces an overall response rate of 20% with an average survival of 8 months and is well tolerated by the elderly. Vinorelbine, when used alone, improves the quality of life for patients and extends survival by approximately 7 weeks versus those receiving only palliative care (care to ensure comfort with no curative intent). A recent clinical trial in Italy evaluated the combination of both Gemzar and vinorelbine as treatment of patients 70 years or older with advanced NSCLC. One hundred and twenty patients were treated with either a combination of Gemzar plus vinorelbine or vinorelbine alone. Forty-nine patients had stage IIIB NSCLC and 71 had stage IV. The overall response rates were 22% for patients receiving the combination treatment and 15% for vinorelbine alone. One year after treatment, the survival rates were 30% for patients receiving Gemzar plus vinorelbine and 13% for patients receiving vinorelbine alone. The patients receiving combination therapy reported a delay in negative symptoms caused by the cancer and an improved quality of life over those receiving vinorelbine alone. 

     The results from this study indicate that the combination of Gemzar and vinorelbine is a well tolerated treatment option for elderly patients with advanced stage NSCLC, and may improve survival time and quality of life. Elderly persons with NSCLC may wish to talk with their doctor about the risks and benefits of receiving this combination of chemotherapy or participation in a clinical trial utilizing other promising new therapies. 

     Two sources of information on ongoing clinical trials include clinical trials listing services provided by the National Cancer Institute (cancertrials.nci.nih.gov) and eCancerTrials.com. eCancerTrials.com also performs personalized clinical trial searches on behalf of patients. (Journal of Clinical Oncology, Volume 18, No 13, pp2529-2536, 2000)

© Cancer Treatment Consultants. All Rights Reserved.