Khant zaw aung


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Khant zaw aung

  1. 1. Scientific supervisor : Prof Dr. B.I.Polyakov Dr . A.F. Marebuch Presented by Dr. Khant Zaw Aung Gemcitabine/Cisplatin And Paclitexal/Carboplatin Combinations In Treatment Of Non-small Cell Lung Cancer Stage IIIB And IV As First Line Of Treatment (ECOG PS <2) M.V. Lomonosov Moscow State University Faculty of Basic Medicine
  2. 2. <ul><li>Lung cancer is highly lethal, with the highest record 5 years survival rate of 14% observed in united state. </li></ul><ul><li>Lung cancer is subdivided into small cell lung cancer (20-25%) and non-small cell lung cancer(75-80%) . </li></ul><ul><li>NSCLC is also histologically subdivided into adenocarcinoma, squamous cell carcinoma ,large cell carcinoma ,bronchoalveolar carcinoma and undifferentiated carcinoma. </li></ul>
  3. 3. <ul><li>There are many risk factors of NSCLC but the primary risk factor for lung cancer is smoking , which account for >85% of lung cancer related death. </li></ul><ul><li>The treatment of NSCLC is based upon the stage of the disease. In early stage, surgery followed by chemotherapy ,biotherapy and radiotherapy is main stay but in the late stage the prognosis is poor. So chemotherapy is the main stay in late stage. </li></ul>
  4. 4. <ul><li>To study the efficacy and toxicities of treatment of gemcitabine/cisplatin combination and paclitexal /carboplatin combination in NSCLC stage IIIB and IV patients of ECOG PS<2 as first line chemotherapy. </li></ul>
  5. 5. <ul><li>Objectives </li></ul><ul><li>To show that platinum based combination are effective in NSCLC. </li></ul><ul><li>To identify that GC combination is better response than CbP combination. </li></ul><ul><li>To know that haematological toxicities are more common in GC combination. </li></ul><ul><li>To determine that patients’ demographic with response are not significantly difference between the two arms. </li></ul>
  6. 6. <ul><li>Patients And Treatment Programme </li></ul><ul><li>Retrospective study </li></ul>53 Patients Gemcitabine 1,000-1,2500 mg/m2 IV over 30 minutes on day 1 and 8 + Cisplatin 50-80 mg/m2 IV over 1 hr on day 1 Paclitexal 175-200mg/m2 IV over 3 hrs on day 1 + Carboplatin (AUC 5 or 6) IV over 30 minutes on day 1 29 patients 24 patients Proper premdications, antiemetic therapy and prehydration therapy before treatment. Proper premdications and standard antiemetic therapy before treatment Cycles are repeated at 3 weeks interval.
  7. 7. <ul><li>Follow up </li></ul><ul><li>After completing the primary therapy, patients were followed up annually. Follow-up included physical examination, blood chemistry and evaluation of tumour markers , chest X-ray, upper abdominal ultrasonography. </li></ul><ul><li>Computerized tomography and magnetic resonance imaging (MRI) were done if required. </li></ul><ul><li>According to the patient’s status, response to treatment and progression, further therapy are given. </li></ul>
  8. 8. Arm specific Demographic
  9. 9. Arm specific Demographic (continued)
  10. 10. Arm-Specific Demographics With Response
  11. 11. Arm-Specific Demographics With Response (continued) Correlation with Staging %
  12. 12. Haematological toxicities GC combination CbP combination
  13. 13. Non-haematological toxicities GC combination CbP combination Patients Patients Grade I Grade II
  14. 14. Response Rate <ul><li>There is no complete response in this study. </li></ul>
  15. 15. % Therapeutic Outcome
  16. 16. <ul><li>This study revealed that gemcitabine/cisplatin combination is better response than paclitexal / carboplatin combination but not statisticaly significant . </li></ul><ul><li>Haematological toxicities are more common in gemcitabine/cisplatin combination. </li></ul><ul><li>This study showed that patients demographic with response are not significantly difference between the two arms. </li></ul><ul><li>We also noted that platinum based combinations are effective in non-small cell lung cancer patients but proper premedications must be given. </li></ul>
  17. 17. <ul><li>Early stage of non-small cell lung cancer can be cured by surgery followed by chemotherapy, radiotherapy and biotherapy but we will know that it can be recurrent. So follow up after the treatment is also important . </li></ul><ul><li>Smoking is the major risk factor for non-small cell lung cancer.So that we must educate the people not to smoke and we must do the health education programme for prevention of the disease. </li></ul><ul><li>Because of the poor prognosis of the late stage of non-small cell lung cancer, the aim of this stage is to support the quality of life ,to relieve the symptoms and to longer the duration of life. </li></ul>
  18. 18. THANK YOU