Abstract 57P
Background
Squamous cell carcinoma accounts for about 20% of all lung cancers. Gemcitabine-cisplatin and paclitaxel-carboplatin are the two commonly used combination chemotherapeutic regimens in advanced squamous cell carcinoma of lung where we have no access to the novel therapeutics such as immunotherapy, with proven benefit in terms of response rate, survival, and also they are tolerated by the majority of patients.
Methods
This prospective observational study was conducted in patients diagnosed with stage IV squamous cell carcinoma of lung in the department of Radiation Oncology of Government Medical College, Trivandrum, from April 2018-September 2019. Due to the non-availability of PDL1 testing and novel immunotherapeutics, these patients were started on palliative chemotherapy either with gemcitabine-cisplatin and paclitaxel-carboplatin. After 4 cycles of chemotherapy CT thorax taken was assessed for the tumour response to treatment. The primary outcome was overall response rate (ORR), which was defined as per Response Evaluation Criteria In Solid Tumors (RECIST) criteria, after completion 4 cycles of chemotherapy. Secondary outcome includes the incidence and grade of toxicity of the above two regimens.
Results
194 patients were taken up for the study. Overall response was 26% in paclitaxel-carboplatin arm and 27% in gemicitabine-cisplatin arm (p value- 0.76) and it was not statistically significant among the 2 regimens. Grade 3 and 4 anemia and neutropenia was seen more with paclitaxel-carboplatin compared to gemcitabine cisplatin (4% vs 0% and 4% vs 0%) (p value < 0.01). Grade 3 and 4 thrombocytopenia was also seen more among paclitaxel-carboplatin than in gemicitabine-cisplatin and it was statistically significant (4% vs 0%; p value < 0.01). Grade 3 and 4 nausea & vomiting was seen more in the gemicitabine-cisplatin arm but it was not statistically significant (8% vs 4%); (pvalue 0.07). There was no grade 3 or 4 renal toxicity, electrolyte abnormality or hearing loss in our study population.
Conclusions
We concluded that the overall response rate was similar in both treatment groups. Therefore both can be viewed as an acceptable option when we have no access to novel immunotherapeutics.
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.