ORLANDOThe 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(Drug information on docetaxel) (Taxotere) plus a platinum agent achieved better QOL than a standard regimen of vinorelbine (Navelbine) and cisplatin(Drug information on 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(Drug information on 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 days.
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.