Scientific supervisor : Prof Dr. B.I.Polyakov

Dr . A.F. MarebuchPresented by Dr. Khant Zaw Aung

Gemcitabine/CisplatinGemcitabine/Cisplatin And Paclitexal/Carboplatin Combinations In And Paclitexal/Carboplatin Combinations In Treatment Of Non-small Cell Lung Cancer Stage IIIB And IV As First Treatment Of Non-small Cell Lung Cancer Stage IIIB And IV As First

Line Of Treatment (ECOG PS <2)Line Of Treatment (ECOG PS <2)

Gemcitabine/CisplatinGemcitabine/Cisplatin And Paclitexal/Carboplatin Combinations In And Paclitexal/Carboplatin Combinations In Treatment Of Non-small Cell Lung Cancer Stage IIIB And IV As First Treatment Of Non-small Cell Lung Cancer Stage IIIB And IV As First

Line Of Treatment (ECOG PS <2)Line Of Treatment (ECOG PS <2)

M.V. Lomonosov Moscow State UniversityFaculty of Basic Medicine

Lung cancer is highly lethal, with the highest record 5 years survival rate of 14% observed in united state.

Lung cancer is subdivided into small cell lung cancer (20-25%) and non-small cell lung cancer(75-80%) .

NSCLC is also histologically subdivided into adenocarcinoma, squamous cell carcinoma ,large cell carcinoma ,bronchoalveolar carcinoma and undifferentiated carcinoma.

There are many risk factors of NSCLC but the primary risk factor for lung cancer is smoking , which account for >85% of lung cancer related death.

The treatment of NSCLC is based upon the stage of the disease. In early stage, surgery followed by chemotherapy ,biotherapy and radiotherapy is main stay but in the late stage the prognosis is poor. So chemotherapy is the main stay in late stage.

To study the efficacy and toxicities of treatment of gemcitabine/cisplatin combination and paclitexal /carboplatin combination in NSCLC stage IIIB and IV patients of ECOG PS<2 as first line chemotherapy.

ObjectivesObjectives

To show that platinum based combination are To show that platinum based combination are effective in NSCLC.effective in NSCLC.

To identify that GC combination is better response To identify that GC combination is better response than CbP combination.than CbP combination.

To know that haematological toxicities are more To know that haematological toxicities are more common in GC combination.common in GC combination.

To determine that patients’ demographic with To determine that patients’ demographic with response are not significantly difference between the response are not significantly difference between the two arms.two arms.

Patients And Treatment ProgrammePatients And Treatment Programme Retrospective study

53 Patients

Gemcitabine 1,000-1,2500 mg/m2 IV over 30 minutes

on day 1 and 8+

Cisplatin 50-80 mg/m2 IV over 1 hr on day 1

Paclitexal 175-200mg/m2 IV over 3 hrs on day 1

+Carboplatin (AUC 5 or 6)

IV over 30 minutes on day 1

29 patients

24 patients

Proper premdications, antiemetic therapy and prehydration therapy

before treatment.

Proper premdications and standard antiemetic

therapy before treatment

Cycles are repeated at 3 weeks interval.

Follow up After completing the primary therapy,

patients were followed up annually. Follow-up included physical examination, blood chemistry and evaluation of tumour markers , chest X-ray, upper abdominal ultrasonography.

Computerized tomography and magnetic resonance imaging (MRI) were done if required.

According to the patient’s status, response to treatment and progression, further therapy are given.

Arm specific Demographic Arm specific Demographic

Arm specific Demographic Arm specific Demographic (continued)(continued)

Arm-Specific Demographics With ResponseArm-Specific Demographics With Response

Arm-Specific Demographics With Response Arm-Specific Demographics With Response (continued)(continued)

Correlation with StagingCorrelation with Staging

%

Haematological toxicitiesHaematological toxicities

GC combination

CbP combination

Non-haematological toxicitiesNon-haematological toxicities

GC combination

CbP combination

Patie

nts

Patie

nts

Grade IGrade II

Response RateResponse Rate

There is no complete response in this study.

%

Therapeutic Outcome

This study revealed that gemcitabine/cisplatin combination is better response than paclitexal / carboplatin combination but not statisticaly significant .

Haematological toxicities are more common in gemcitabine/cisplatin combination.

This study showed that patients demographic with response are not significantly difference between the two arms.

We also noted that platinum based combinations are effective in non-small cell lung cancer patients but proper premedications must be given.

Early stage of non-small cell lung cancer can be cured by surgery followed by chemotherapy, radiotherapy and biotherapy but we will know that it can be recurrent. So follow up after the treatment is also important .

Smoking is the major risk factor for non-small cell lung cancer.So that we must educate the people not to smoke and we must do the health education programme for prevention of the disease.

Because of the poor prognosis of the late stage of non-small cell lung cancer, the aim of this stage is to support the quality of life ,to relieve the symptoms and to longer the duration of life.

THANK YOUTHANK YOU