According to a study presented at the 11th Annual European Cancer Conference, patients with advanced non-small-cell lung cancer (NSCLC) who received docetaxel(Drug information on docetaxel) (Taxotere) in combination with cisplatin(Drug information on 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(Drug information on 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.