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Improved QOL With Docetaxel/Platinum Regimens in NSCLC Patients

Improved QOL With Docetaxel/Platinum Regimens in NSCLC Patients

ORLANDO—The largest prospective evaluation of quality of life (QOL) in
chemotherapy-naïve patients with advanced non-small-cell lung cancer (NSCLC)
found that first-line treatment with docetaxel (Taxotere) plus a platinum agent
achieved better QOL than a standard regimen of vinorelbine (Navelbine) and
cisplatin (Platinol).

Richard J. Gralla, MD, professor of medicine, Columbia University College of
Physicians & Surgeons, reported the results of TAX 326 at the 38th Annual
Meeting of the American Society of Clinical Oncology (abstract 1196).

In short, he said, QOL differences were found among the treatment arms at
all treatment cycles favoring the docetaxel/cisplatin and docetaxel/carboplatin
(Paraplatin) arms, compared with vinorelbine/cisplatin.

The study included 1,218 patients from 28 countries and 140 institutions.
Approximately two thirds of the patients had stage IV disease, and about one
third had metastases to at least three organs.

Patients were randomized to one of three treatment arms: Arm A was docetaxel 75
mg/m² plus cisplatin 75 mg/m² every 21 days. Arm B was docetaxel
75 mg/m² plus carboplatin to AUC 6 every 21 days. Arm C was vinorelbine 25
mg/m² on days 1, 8, 15, and 22 plus cisplatin 100 mg/m² on day 1 every 28

The study was designed to compare Arm A and Arm B, respectively, with Arm C,
which was a standard chemotherapy doublet. Arm A and Arm B were not directly
compared with each other, nor was cisplatin compared with carboplatin, Dr.
Gralla noted.

The clinical endpoints analysis of TAX 326, previously reported, showed a
significant improvement in survival favoring docetaxel/cisplatin (median
survival, 11.3 months vs 10.1 months for vinorel-bine/cisplatin, P = .044).
Two-year survival was 21% vs 14%, respectively. There was no significant
difference in median survival for docetaxel/carboplatin vs vinorelbine/cisplatin.


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