Tolerability and toxicity of adjuvant cisplatin and gemcitabine for treating non-small cell lung cancer.

Background: The combination of cisplatin and vinorelbine is an evidence-supported regimen for adjuvant chemotherapy for treating non-small cell lung cancer (NSCLC). But this doublet has considerable toxicity and unfavorable tolerability, and results in poor compliance. The cisplatin and gemcitabine regimen is one of the most active and well-tolerated regimens against advanced NSCLC, but its toxicity and tolerability has not been adequately evaluated in the adjuvant setting.
Methods: From a lung cancer database we retrospectively reviewed NSCLC patients receiving adjuvant chemotherapy of cisplatin (75 mg/m(2)) and gemcitabine (1250 mg/m(2)) between January 2005 and December 2011. Postoperative demographics, compliance to adjuvant therapy and toxicity were retrieved from medical records.
Results: A total of 132 patients met the criteria and were included in the study, 96 were male (72.7%) and 36 were female (27.3%). Median age was 60.5 years old, range 29 - 75 years, and 41.7% of patients were ≥ 65 years old. Overall, 68.2% patients received all four planned cycles, and the cumulative dose delivered for gemcitabine was 8333 mg (83.3% of the planned dose) and cisplatin 248 mg (82.7% of the planned dose). There were no treatment-related deaths. Grade 3/4 neutropenia developed in 47 patients (35.6%) and was the predominant hematologic toxicity. Common grade 3/4 non-hematologic toxicities were nausea/vomiting (22.0%), infection (12.3%), and febrile neutropenia (11.4%).
Conclusion: Cisplatin and gemcitabine are feasible for use in the adjuvant setting with a favorable toxicity profile and superior tolerability compared with published data on cisplatin and vinorelbine.