Randomized cross-over study of patient preference for oral or intravenous vinorelbine in combination with carboplatin in the treatment of advanced NSCLC

Summary 

Background

Most chemotherapeutics are administrated intravenously (IV), but some are also available in an oral (PO) formulation. This study was designed with the primary objective to estimate the patients’ preference for PO or IV vinorelbine in combination with carboplatin for the palliative treatment of non-small cell lung cancer (NSCLC). Secondary aims were to evaluate toxicity, efficacy, and subjective reasons the preference.

Patients and methods

Sixty-one patients were randomized in a cross-over trial to two cycles of carboplatin day 1 and vinorelbine day 1 and day 8 IV followed by two cycles of carboplatin and vinorelbine PO, or the opposite. Patients, who did not show progressive disease after four cycles, had a free choice of IV or PO vinorelbine for the next two cycles.

Results

Forty-three patients were evaluable for preference and 32 (74%, 95% CI 61–88%) chose PO (p<0.001). The response rate was 23% and median survival 11.4 months. Patients with preference for PO treatment stated that side effects were less with capsules and that daily life was less affected by capsules.

Conclusion

Three out of four patients preferred oral vinorelbine. Clinical outcomes were comparable to other combination chemotherapy regimens for NSCLC.

Keywords: Patient preference, Oral chemotherapy, NSCLC, Vinorelbine, Combination chemotherapy, Carboplatin