RESUMO
BACKGROUND: Matrix metalloproteinase (MMP)-9 and vascular endothelial growth factor (VEGF) are two proteins involved in angiogenesis. In the present study we investigated the association of pretreatment MMP-9 and VEGF serum levels with clinicopathological parameters and outcome in patients with non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: From February 1998 to October 1999, pretreatment serum levels of MMP-9 and VEGF were analysed in 118 patients with enzyme-linked immunoassays. At diagnosis 50 patients (42%) were staged as early disease (I/II), 27 patients (23%) as locally advanced (IIIA/IIIB), and 41 patients (35%) had metastatic disease (IV). In 72 of the 118 patients tumours were resected and 46 patients received combination chemotherapy with gemcitabine and vinorelbine. RESULTS: The median survival of all 118 patients was 602 days. The 72 patients who had undergone surgery had a median survival of 972 days and the 46 patients who were treated with chemotherapy had a median survival of 298 days (P <0.001). Resected patients with stage I/II disease and an MMP-9 serum level Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
, Biomarcadores Tumorais/análise
, Carcinoma Pulmonar de Células não Pequenas/patologia
, Desoxicitidina/análogos & derivados
, Fatores de Crescimento Endotelial/sangue
, Peptídeos e Proteínas de Sinalização Intercelular/sangue
, Neoplasias Pulmonares/patologia
, Linfocinas/sangue
, Metaloproteinase 9 da Matriz/sangue
, Vimblastina/análogos & derivados
, Adulto
, Idoso
, Idoso de 80 Anos ou mais
, Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico
, Desoxicitidina/administração & dosagem
, Ensaio de Imunoadsorção Enzimática
, Feminino
, Nível de Saúde
, Humanos
, Neoplasias Pulmonares/tratamento farmacológico
, Masculino
, Pessoa de Meia-Idade
, Estadiamento de Neoplasias
, Prognóstico
, Sobrevida
, Resultado do Tratamento
, Fator A de Crescimento do Endotélio Vascular
, Fatores de Crescimento do Endotélio Vascular
, Vimblastina/administração & dosagem
, Vinorelbina
, Gencitabina
RESUMO
The purpose of this phase II study was to investigate the efficacy and safety of gemcitabine plus vinorelbine as first-line chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). Eligibility criteria included cytologically or histologically confirmed NSCLC (stage IIIB or IV), no previous chemotherapy, and bidimensionally measurable disease. Patients received 1000 mg/m(2) gemcitabine and 30 mg/m(2) vinorelbine on days 1, 8 and 15 every 4 weeks up to eight courses. From December 1997 to November 1998, 70 patients (59 stage IV and 11 stage IIIB disease), with a median age of 59 years (range 38-74 years) were enrolled. The intent-to-treat response rate was 41% (95% confidence interval (CI) 30-54%) with 1 complete responder (CR) and 28 partial responders (PRs), 15 patients had stable disease (SD) and 26 progressed (PD). Median survival was 8.3 months (95% CI 6.0-9.9 months), median progression-free survival (PFS) was 4.8 months (95% CI 3.9-5.5 months), and 1-year survival rate was 33.5% (95% CI 24.0-46.8%). Patients received a total of 229 cycles. Haematological and non-haematological toxicities were moderate. Transient World Health Organization (WHO)-grade IV leucopenia and thrombocytopenia occurred in 13 (6%) and two (1%) cycles, respectively. The predominant non-haematological toxicity was local reactions of the veins in 19 (27%) patients (WHO-grade II and III). Neurotoxicity was infrequent, non-cumulative, and reversible. The combination of gemcitabine and vinorelbine has demonstrated activity in metastatic NSCLC, with response and survival rates similar to those of cisplatin-based regimens and a more favourable toxicity profile that is well tolerated in an outpatient setting.