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Combination Chemotherapy Should Be Standard of Care for Lung Cancer

Combination Chemotherapy Should Be Standard of Care for Lung Cancer

Combination chemotherapy should be the
standard treatment for patients with advanced non-small-cell lung cancer,
according to a study presented at the 38th annual meeting of the American
Society of Clinical Oncology (ASCO). The phase III, randomized study compared
the combination of carboplatin (Paraplatin) and paclitaxel with paclitaxel alone
and showed that patients in the combination arm achieved a statistically
significant better response (29%) than patients in the paclitaxel alone arm
(17%).

Survival Duration Increased

"Not only did the results of the trial show an increase
in response rate, but more importantly, an increase in survival time in patients
who received carboplatin and paclitaxel," said Dr. Rogerio Lilenbaum,
director of the Thoracic Oncology Program at the Mount Sinai Cancer Center in
Miami Beach and lead investigator of the study for the Cancer and Leukemia Group
B (CALGB). "In addition, the results of the study clearly demonstrate that
elderly patients and the sickest patients may benefit from this regimen."

Patients in the study who received the combination achieved a
median survival of 8.8 months, compared with 6.7 months for patients who
received paclitaxel alone. This represents a 24% increase in the duration of
survival for those in the combination-therapy arm. In addition, patients in the
combination arm experienced a longer failure-free survival (4.6 vs 2.5 months).

Equivalent Toxicities

"Typically, patients treated with combination
chemotherapy experience more severe toxicity than those treated with single
agents," said Dr. Richard L. Schilsky, associate dean for clinical
research, University of Chicago, and chairman, CALGB. "However, the
combination of carboplatin and paclitaxel resulted in only minimal increases in
toxicity levels."

Although toxicity levels are slightly higher with combination
therapy, the quality of life for patients was not compromised. The most common
toxicity for each regimen was a decrease in the absolute neutrophil count (62%
for the combination vs 32% for paclitaxel alone). Other side effects included
febrile neutropenia (8% with the combination vs 5% with paclitaxel alone) and
peripheral neuropathy (15% with the combination vs 13% with paclitaxel alone).

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