Combination chemotherapy improves survival in advanced NSCLC based on numerous reports. Cisplatin based chemotherapy has remained the standard regimen used in most studies. This study was designed to compare 3 different chemotherapy regimens, 2 containing cisplatin and one non cisplatin based regimen.
Materials and Methods:
480 patients randomized with 10 patients non- eligle for analysis
Patients were randomized between Cisplatin/Paclitaxel (Arm A), Cisplatin/Gemcytabine (Arm B), and Gemcytabine/Paclitaxel (Arm C)
Patient characteristics were well balanced between arms
There was no difference in response rates between the control arm (A) and experimental arms (B and C).
There was no significant difference in median survival between the arms
Arm B had an increased incidence of thrombocytopenia and anemia, but no increased incidence of clinical complications.
There was no significant difference in non hematologic toxicity
Both experimental arms failed to show superiority over the control arm
There was increased hematologic toxicity with the Gemcytabine/Cisplatin combination without increased clinical complications
Quality of life analysis is ongoing
This trial is disappointing for non cisplatin based chemotherapy supporters
Future reference regimens should include cisplatin
Questions remain if higher doses of paclitaxel will show a benefit than those used in this study
Jul 23, 2010 - Bevacizumab used in combination with standard chemotherapy for advanced non-squamous non-small-cell lung cancer (NSCLC) has a generally manageable safety profile, according to an open-label, single group, phase 4 study published online July 21 in The Lancet: Oncology.