ECOG randomized patients with advanced NSCLC to 1 of 4 new 3 of the 4 regimens used in ECOG docetaxel/cisplatin, paclitaxel/cisplatin. In the ECOG trial, the only direct comparison of similar regimens, response rates and survival times were similar between patients treated with cisplatin. ECOG was chosen as a plenary session presentation because it is an important trial that reflects the state of care in of metastatic NSCLC—the.

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A common manageable adverse event for the taxane-platinum combinations has been neutropenia. However, there is no consistent evidence that combination chemotherapy without platinum is better than third generation drugs given as single agents. Paclitaxel is a natural product isolated from the Pacific yew, whereas docetaxel is a semisynthetic taxane analogue of the European yew. Previous Section Next Section. Chemotherapeutic management of stage IV non-small cell lung cancer.

Grade 3 or 4 neutropenia, anemia, nausea and vomiting, and constipation were more common with VC, while grade 3 or 4 thrombocytopenia was more common with PCb and GC. The primary end point was overall survival, and the study was designed to compare each docetaxel arm with the vinorelbine arm; there was no intention of comparing the eog docetaxel arms [ 13 ].

Pharmacokinetics and pharmacodynamics of the taxanes.

The JCOG data show a prolongation of survival using irinotecan compared to etoposide when combined with cisplatin. Second, given a cytostatic rather edog cytotoxic mechanism of action, these agents are more likely to be effective when they are administered continuously rather than in pulses, and oral formulations are preferred for continuous dosing schedules, with obvious logistic advantages for patients. The objective response rates were similar in both treatment groups: Current Issue December23 Results and conclusions of the meeting were presented on 15 and 16 April to about clinical oncologists coming from all over Italy.

The study confirmed a substantial incidence of grade 3 and grade 4 toxicities in PS2 patients, although not significantly higher than in patients with better PS. scog

For this latter sub-group, there is no treatment widely accepted as standard and oncologists have to choose among several treatment options for which PS2 patients are potential candidates: Various chemotherapy regimens have been evaluated in an attempt to improve on exog outcomes achieved with BSC.

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Patients with a performance status of 2 had a significantly lower rate of survival than did those with a performance status of 0 or 1.

The hazard ratio of survival for combination chemotherapy was 1 when compared with vinorelbine and 0. In that study, a comparison of mean baseline score with mean score after 6 weeks was planned.

Early results of a randomized phase III trial of platinum-containing doublets versus a nonplatinum doublet in the treatment of advanced non-small cell lung cancer: The major question is whether toxicity will prohibit further development of this agent.

Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review

Have we made any progress in the treatment of advanced non-small cell lung cancer NSCLC over the past 15 years? In addition, patients treated with docetaxel demonstrated improvements in clinical benefit parameters. Search for related content. Taking into account the superiority shown by the carboplatin—paclitaxel combination compared to paclitaxel alone, even 154 PS2 patients, in one clinical trial [ 37 ], carboplatin-based doublets may also be considered as an alternative option in a selected sub-group of patients.

Results and conclusions of that meeting are presented in this paper. American College of Chest Physicians.

Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review

A total of patients with advanced non-small-cell lung cancer were randomly assigned to a reference regimen of cisplatin and paclitaxel or to one of three experimental regimens: Patients treated with cisplatin underwent hydration and received antiemetics. Participation of patients 65 years of age or older in cancer clinical trials.

A consortium of centers led by Dr. The end points for these large randomized clinical trials were survival, response rate, adverse events, and quality of life QOL.

Proc Am Soc Clin Oncol ; The Japanese study showed an impressive survival advantage to the newer combination. There were no significant differences in terms of response, median survival or one-year survival.

Phase III randomized trial comparing three platinum-based doublets in advanced non-small-cell lung cancer. Some of the trials comparing best supportive care plus eco versus best supportive care alone are summarised in Table 2. Selected grade 3 or 4 toxicities reported in large phase III clinical trials: These numbers show that in the last few years there has been a tendency to limit participation eco randomised trials to fit patients, excluding PS2 patients.


The data with four cycles in these two most recently completed studies are remarkably similar to data using six cycles of therapy, leading Dr. Therefore, single-agent chemotherapy with these drugs e. This study is one of the first to randomly compare a novel agent with chemotherapy versus chemotherapy alone. Recent randomised trials of platinum-free versus platinum-based combination chemotherapy in advanced NSCLC.

Lung Cancer Highlights

Effects of vinorelbine on quality of life and survival of elderly patients with advanced non small cell lung cancer. The primary outcome measure was overall survival [ 14 ]. Proc Am Soc Clin Oncol. Clin Cancer Res ; ecig User Name Password Sign In. Different patients may have different benefit, different compliance and different toxicities from the same anti-cancer treatment.

A neutropenia, B febrile neutropenia, and C peripheral neuropathy. A worse PS is characterised by lower response rates to chemotherapy, shorter time to treatment failure and shorter progression-free survival [ 2728 ]. For example, a year-old PS2 patient confined to bed for a painful single bone metastasis is different from an elderly patient confined to bed for a moderate ecpg severe cardiovascular co-morbidity.

Eco quality of life in non-small-cell lung cancer: As for the role of carboplatin, the results of the CALGB study, comparing paclitaxel ceog carboplatin versus paclitaxel alone, must be considered [ 37 ].

Although they share a common mechanism of action, there are several differences in the pharmacokinetics and pharmacologic actions of the two taxanes. How important is response rate? Of the taxane-platinum combinations tested, docetaxel-cisplatin was the only platinum combination to yield survival and response rates superior to another platinum combination.