Feasible combination chemotherapy with nedaplatin and irinotecan for patients with non-small cell lung cancer and multiple high-risk factors.

We retrospectively analyzed the outcome of high-risk patients with non-small cell lung cancer (NSCLC) treated with nedaplatin (NP) and irinotecan (CPT) combination chemotherapy. Between July 2002 and January 2006, 31 NSCLC patients with multiple high-risk factors were treated with NP at 50 mg/m2 and CPT at 50 mg/m2 on days 1 and 8 every 4 weeks. Among them, the patients had a total of 85 risk factors, including poor performance status (2 or 3) in 27, cardiac or pulmonary failure in 15, symptomatic bone or brain metastasis in 9, and advanced age (> or = 75 years) in 8, as well as other factors. A total of 83 courses of the chemotherapy were administered and 24 patients were able to receive 2 to 4 courses. With regard to toxicities, 7 (8.4%) and 11 courses (13%) were associated with grade 4 neutropenia and grade 3 febrile neutropenia, respectively. One patient suffered acute myocardial infarction. Each of the toxicities was controllable and there were no treatment-related deaths. One patient achieved CR, 13 achieved PR, 14 SD and 3 PD, and the overall response rate was 45.2%. Of 26 patients with stage IIIB or IV, the median survival time was 232 days, the 1-survival rate was 38.5%, and 3 patients survived for more than 3 years. In conclusion, chemotherapy with NP and CPT appears to be safe and highly effective for high-risk patients with NSCLC.