Timing of Gemcitabine + Platinum Chemotherapy-Induced Neutropenia is Associated with Lung Cancer Survival Times

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(ChemotherapyAdvisor) – Early-onset but not late-onset chemotherapy-induced neutropenia is a favorable prognostic factor for patients undergoing gemcitabine plus platinum doublet chemotherapy for metastatic non-small cell lung cancer (NSCLC), according to a retrospective study published in the Journal of Cancer Research and Clinical Oncology.

“Better clinical outcomes were achieved when onset of neutropenia was early versus late or absent,” reported lead author Seung Hun Jang of Hallym University College of Medicine, in Gyeonggi, Korea, and coauthors.

While chemotherapy-induced neutropenia overall is widely seen as a favorable prognostic factor for survival among patients with NSCLC, this study was the first to establish an association between the timing of neutropenia onset and patient survival times, the authors noted.

The team studied data from 123 patients with stage IV NSCLC who underwent at least 2 cycles of first-line doublet gemcitabine plus platinum chemotherapy. Chemotherapy-induced neutropenia was categorized as early-onset (lowest neutrophil count of cycles 1-2 <2.0 x 109/L) and non-early-onset, subdivided into absent and late-onset (lowest neutrophil count of cycles 3-6 <2.0 x109/L) categories.

“Significantly better disease control rate, progression-free survival (PFS), and overall survival (OS) were observed in early-onset versus non-early-onset patients,” the authors reported. “Median PFS of 5.1 and 3.8 months (P=0.0016) and median OS of 16.7 and 11.2 months (P=0.00004) were achieved for these two groups, respectively.”

Patients in the non-early-onset group had “similarly poor clinical outcomes” whether neutropenia was absent or had a late onset (median PFS 4.8 vs 3.8 months; P=0.506, n.s.; median OS 13 vs 11.2 months; P=0.630, n.s.), the authors wrote.

Similar research is “warranted” to determine whether or not the team's findings are also evident in other chemotherapy regimens, they wrote.


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