This Article Full Text Full Text (PDF) eLetters: Submit a response to this article Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Le Chevalier, T. Articles by Cigolari, S. Search for Related Content PubMed PubMed Citation Articles by Le Chevalier, T. Articles by Cigolari, S.

Long Term Analysis of Survival in the European Randomized Trial Comparing Vinorelbine/Cisplatin to Vindesine/Cisplatin and Vinorelbine Alone in Advanced Non-Small Cell Lung Cancer

Institut Gustave-Roussy, Villejuif Cedex, France

Correspondence: Thierry Le Chevalier, M.D., Institut Gustave-Roussy, Rue Camille Desmouline, Villejuif Cedex 94805 France. Telephone: 33-1-455-943-22; Fax: 33-1-421-152-19; e-mail: tle-che{at}iqr.br

In the period 1989-1991, 612 patients with inoperable stage IIIA/B and IV non-small cell lung cancer (NSCLC) were randomized in a phase III trial comparing three chemotherapy regimens. Survival data at five and six years of follow-up confirm the overall benefit of treatment with a combination of vinorelbine and cisplatin compared to vindesine plus cisplatin or vinorelbine alone. Of the 612 patients randomized at the start of the study, 17 have survived beyond five years. Of these patients, eight had entered the trial with metastatic disease. Multivariate analysis to detect prognostic factors suggested a possible interaction between the effect of having cisplatin in the chemotherapy received and baseline performance status. Subgroup analysis subsequently confirmed that the survival benefit of the vinorelbine plus chemotherapy regimen is evident only in patients with initial World Health Organization performance status (PS) of 0-1. Among these patients, the one-year survival rate is 38% for the vinorelbine/cisplatin arm, 29% for vindesine/cisplatin and 34% for vinorelbine alone. The corresponding figures for median survival are 43, 33 and 36 weeks. Among inoperable NSCLC patients with a PS of 2, who appear from this trial not to have benefited from the presence of cisplatin in their chemotherapy, use of single agent vinorelbine is an appropriate treatment option.

Key Words. Vinorelbine • Cisplatin • Vindesine • Randomized study • Prognostic factors

This article has been cited by other articles:

				C. J. Langer The "Lazarus Response" in Treatment-Naive, Poor Performance Status Patients With Non-Small-Cell Lung Cancer and Epidermal Growth Factor Receptor Mutation J. Clin. Oncol., March 20, 2009; 27(9): 1350 - 1354. [Full Text] [PDF]

				J.-P. DELORD, C. PUOZZO, F. LEFRESNE, and R. BUGAT Combination Chemotherapy of Vinorelbine and Cisplatin: A Phase I Pharmacokinetic Study in Patients with Metastatic Solid Tumors Anticancer Res, February 1, 2009; 29(2): 553 - 560. [Abstract] [Full Text] [PDF]

				C. Langer, S. Li, J. Schiller, W. Tester, B. L. Rapoport, and D. H. Johnson Randomized Phase II Trial of Paclitaxel Plus Carboplatin or Gemcitabine Plus Cisplatin in Eastern Cooperative Oncology Group Performance Status 2 Non-Small-Cell Lung Cancer Patients: ECOG 1599 J. Clin. Oncol., February 1, 2007; 25(4): 418 - 423. [Abstract] [Full Text] [PDF]

				M. Sullivan, K. Hahn, and J. M. Kolesar Azacitidine: A novel agent for myelodysplastic syndromes Am. J. Health Syst. Pharm., August 1, 2005; 62(15): 1567 - 1573. [Abstract] [Full Text] [PDF]

				W. E. Samlowski, S. A. Leachman, M. Wade, P. Cassidy, P. Porter-Gill, L. Busby, R. Wheeler, K. Boucher, F. Fitzpatrick, D. A. Jones, et al. Evaluation of a 7-Day Continuous Intravenous Infusion of Decitabine: Inhibition of Promoter-Specific and Global Genomic DNA Methylation J. Clin. Oncol., June 10, 2005; 23(17): 3897 - 3905. [Abstract] [Full Text] [PDF]

				Y. Kwok, W. F. Regine, and R. A. Patchell Radiation Therapy Alone for Spinal Cord Compression: Time to Improve Upon a Relatively Ineffective Status Quo J. Clin. Oncol., May 20, 2005; 23(15): 3308 - 3310. [Full Text] [PDF]

				Y. Hu, G. Bebb, S. Tan, R. Ng, H. Yan, J. R. Sartor, L. D. Mayer, and M. B. Bally Antitumor Efficacy of Oblimersen Bcl-2 Antisense Oligonucleotide Alone and in Combination with Vinorelbine in Xenograft Models of Human Non-Small Cell Lung Cancer Clin. Cancer Res., November 15, 2004; 10(22): 7662 - 7670. [Abstract] [Full Text] [PDF]

				D. C. Malins, K. M. Anderson, N. L. Polissar, G. K. Ostrander, E. T. Knobbe, V. M. Green, N. K. Gilman, and J. L. Spivak Models of granulocyte DNA structure are highly predictive of myelodysplastic syndrome PNAS, April 6, 2004; 101(14): 5008 - 5011. [Abstract] [Full Text] [PDF]

				D. G. Pfister, D. H. Johnson, C. G. Azzoli, W. Sause, T. J. Smith, S. Baker Jr, J. Olak, D. Stover, J. R. Strawn, A. T. Turrisi, et al. American Society of Clinical Oncology Treatment of Unresectable Non-Small-Cell Lung Cancer Guideline: Update 2003 J. Clin. Oncol., January 15, 2004; 22(2): 330 - 353. [Full Text] [PDF]

				Y. Ohe, S. Niho, R. Kakinuma, K. Kubota, H. Ohmatsu, K. Goto, H. Nokihara, H. Kunitoh, N. Saijo, H. Aono, et al. A phase II study of cisplatin and docetaxel administered as three consecutive weekly infusions for advanced non-small-cell lung cancer in elderly patients Ann. Onc., January 1, 2004; 15(1): 45 - 50. [Abstract] [Full Text] [PDF]

				P. A. Kosmidis In Reply: J. Clin. Oncol., February 15, 2003; 21(4): 756 - 756. [Full Text] [PDF]

				J. L. Gabrilove Hematologic Malignancies: An Opportunity for Targeted Drug Therapy Oncologist, October 1, 2001; 6(2008): 1 - 3. [Full Text] [PDF]

				M. J. Edelman New Directions in the Treatment of Non-Small Cell Lung Cancer: An Overview Oncologist, February 1, 2001; 6(2008): 1 - 3. [Abstract] [Full Text] [PDF]