According to a study presented at the 11th Annual
European Cancer Conference, patients with advanced non-small-cell lung cancer
(NSCLC) who received docetaxel (Taxotere) in combination with cisplatin (Platinol)
achieved better results than those in the control arm, who received vinorelbine
(Navelbine)/cisplatin. Most notably, the 2-year survival rate of the docetaxel/cisplatin
arm was significantly improved over that reported for the control arm: 21% of
the patients in the docetaxel/cisplatin arm were alive after 2 years, compared
to 14% of those treated with vinorelbine/cisplatin (P = .044). The
1-year survival rate in the docetaxel/cisplatin arm was 46%, compared to 41% in
the control arm (P = .044).
Three Treatment Arms
The study enrolled 1,220 patients with previously untreated advanced NSCLC.
Patients were randomized to one of three treatment arms. The first arm received
docetaxel followed by cisplatin every 3 weeks. The second group received
docetaxel followed by carboplatin every 3 weeks, and the third group
received a combination of vinorelbine and cisplatin every 4 weeks. Overall
exposure to chemotherapy was equivalent for all three groups.
In both docetaxel combination arms, quality of life and other clinical
benefit parameters such as body weight, performance status, and pain management
were improved compared to the control arm. In addition, the response rate was
significantly higher in the docetaxel/cisplatin arm than in the control arm (32%
vs 25%, P = .029). Time to progression was similar in both arms.
"The impressive impact on survival and quality of life demonstrated with
the docetaxel/cisplatin combination could profoundly change the treatment
standard of patients with NSCLC," said Frank V. Fossella, MD, medical
director, Thoracic Oncology Multidisciplinary Care Center at The University of
Texas M. D. Anderson Cancer Center in Houston.
Survival and Adverse Effects
The median survival of patients receiving the docetaxel/cisplatin regimen was
11.3 months vs 10.1 months for patients in the control arm (P = .044). The
overall survival of patients in the docetaxel/carboplatin arm was similar to
that of patients in the control arm. However, patients in the control arm
experienced significantly higher rates of nausea and vomiting, while diarrhea
was more common among patients in the docetaxel-based arm.