Gemcitabine (G) and cisplatin (C) in a modified 3-week schedule for non-small cell lung cancer (NSCLC): Impact on hematologic toxicity and dose intensity (DI).

19099 Background: The G+C combination is one of the most widely used treatments for NSCLC. Aimed to enhance DI and reduce toxicity, the original 4-week schedule has been generally modified into a 3-week schedule, decreasing the C dose from 100 to 75-80 mg/sqm and increasing the G dose was from 1000 mg/sqm to 1250 mg/sqm. Others have postponed the C administration from day 1 or 2 to day 8 or 15, in the 4-week schedule, but in the 3-week schedule C administered on day 1 or 2 may hamper the 8 day G dose, due to toxicity. This report presents our experience with a modified 3-week schedule, that we have adopted into the daily clinical practice.,Our pts were treated with G (1000 mg/sqm) on days 1,8 and C on day 8 (100 mg/sqm until January 2004: 75 pts, or 75 mg/sqm from January 2004: 85 pts). The GCSF use was allowed, according to the pts clinical needs. The toxicity was recorded according to the NCIC-criteria.,from October, 2000 to October, 2007 a consecutive series of 160 stage IIIa-IV NSCLC pts (median age 61.5 yrs, range 31- 77) received CG as induction therapy for locally advanced (62 pts) or as palliative treatment for metastatic disease (98 pts). Overall, the pts received 630 chemotherapy courses (median 3, range 2-6, for locally advanced and 4, range 2-9, for metastatic pts). The median DI was 87% (range 34-100). Considering the 8-day dose, 16% of the treatments were delayed due to hematologic toxicities, while in 17% of the cases a GCSF priming after day 1 was necessary. Grade 3-4 hematological toxicities (per pts) were: anemia 3.7%, leukopenia 7.5%, neutropenia 46.8%, thrombocytopenia 5%. In pts with locally advanced disease, a 71% response rate (RR) and 14 mos of median OS were observed. In metastatic pts the RR was 53% and the median OS was 11 mos.,it appears from our experience, that our modified 3-weeks regimen, compared to others 3-weeks CG schedules, has provided a similar DI, is equally active and tolerated but with a better hematologic toxicity profile in terms of anemia and thrombocytopenia. No significant financial relationships to disclose.