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Final overall results of a study with a novel triplet induction chemotherapy regimen (PACCAGE) followed by consolidation radiotherapy in locally advanced inoperable non-small cell lung cancer (NSCLC)
Journal of Thoracic Oncology, 06/01/09

Schallier D et al. – Study reports that the induction chemotherapy with the paclitaxel, carboplatin, and gemcitabine regimen preceding radiotherapy in patients with locally advanced inoperable stage III non-small cell lung cancer (NSCLC) was feasible and active. Long-term survival results of this sequential chemoradiotherapy regimen appear similar to those of concurrent treatment.

Methods

Aim was to examine the long term and overall results of a triplet induction chemotherapy regimen followed by standard radiotherapy in pts with locally advanced inoperable stage III NSCLC
3 cycles of paclitaxel, carboplatin, and gemcitabine were administered every 3 wks
Followed by standard fractionated consolidation radiotherapy starting at least 4 wks after the last chemotherapy administration
Toxicity and antitumor response, progression free and overall survival were assessed

Results

64 pts (25 stage IIIA and 39 stage IIIB) received a total of 179 cycles of chemotherapy
56 received the planned 3 cycles
Full-dose radiotherapy was administered in 73%, a reduced dose in 17% and none in 10%
55% objective response rate (OR) (1 CR and 34 PR) was observed after induction chemotherapy
After completing the whole treatment including radiotherapy, the OR was 85%
Median TTP was 10.9 mo and median OS was 17.2 mo, with a significant difference between stage IIIA and stage IIIB pts
Strongest predictor for a favorable long-term outcome was a metabolic complete response after chemotherapy

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