ECOG randomized patients with advanced NSCLC to 1 of 4 new 3 of the 4 regimens used in ECOG docetaxel/cisplatin, paclitaxel/cisplatin. In the ECOG trial, the only direct comparison of similar regimens, response rates and survival times were similar between patients treated with cisplatin. ECOG was chosen as a plenary session presentation because it is an important trial that reflects the state of care in of metastatic NSCLC—the.
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Topotecan is one of most active new agents for SCLC. First, in terms of survival, in the largest prospective phase III study evaluating the efficacy of a taxane-platinum combination in advanced NSCLC, Fossella and colleagues [ 13 ] reported that DC was modestly superior to VC, with the median survival being about 1 month longer in patients treated with docetaxel. Similar to the benefit observed in the sub-group of elderly patients enrolled in the same trial, these results should be interpreted with caution, in view of the substantial risk of selection bias.
Lung Cancer Highlights
Platinum-based combination chemotherapy is currently recommended as the standard treatment for patients with advanced non-small-cell lung cancer NSCLCbut its benefit seems limited to fit patients with a performance status PS of 0 or 1. A first point of discussion was the evidence supporting the role of chemotherapy itself in PS2 patients.
Survival determinants in extensive-stage non-small-cell lung cancer: These drugs are usually characterised by a good tolerability, with a low incidence of severe adverse events. The end points for these large randomized clinical trials were survival, response rate, adverse events, and quality of life QOL. A total of patients with advanced non-small-cell lung cancer were randomly assigned to a reference regimen of cisplatin and paclitaxel or to one of three experimental regimens: The hazard ratio of survival for combination chemotherapy was 1 when compared with vinorelbine and 0.
The role of adding platinum to third generation single agents in PS2 patients.
Lung Cancer ; The major question is whether toxicity will prohibit further development of this agent. Patients who progressed were taken off the study. Although a substantial improvement in overall survival should obviously be the ideal aim of clinical research, considering the very poor prognosis of PS2 patients irrespective of the treatment administered, patient-related end points other than overall survival symptom relief, clinical benefit, health-related QoL should play a central role in the planning, conducting and analysing of trials dedicated to PS2 patients.
N Engl J Med. Lung cancer mortality in European regions — The primary analysis of the study showed that the combination was more toxic but it did not show advantage over mono-chemotherapy in terms of overall survival.
Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review
Unfortunately data on second-line therapy were not gathered for this study. With their benefits in the key end points of survival, response rate, adverse event profile, and QOL in randomized trials scog advanced NSCLC, docetaxel and docetaxel-based regimens are logical for further evaluation in earlier-stage NSCLC.
Evidence available for each of the following six topics in the treatment of PS2 patients was reviewed: Baseline characteristics were well balanced across treatment groups. For PS2 patients, there is no consensus on standard treatment. Regarding the choice of end points in clinical trials, it should be considered that symptomatic improvement is strongly requested by the patients.
Unfortunately, however, no data on first-line treatments are currently available. In one respect the occurrence of hemoptysis actually supports the activity of this agent from a mechanistic standpoint.
Some of the data considered by the panellists still lack peer-review quality and are possibly not definitive. This is a very reasonable recommendation. Previous Section Next Section.
In recent years, the rapidly expanding knowledge of cancer pathogenesis at a molecular level has provided new 154 for drug discovery, and a great number of new anti-cancer drugs have been developed.
This study is one of the first to randomly compare a novel agent with chemotherapy versus chemotherapy alone.
Efog prophylactic irradiation to 15594 mediastinum prevent fatal hemoptysis? Citing articles via Web of Ecov Abstracts from proceedings of the most important oncology meetings, not yet published as full papers, were also considered. J Clin Oncol ; Email alerts New issue alert. In the ECOG trial, the only direct comparison of similar regimens, response rates and survival times were similar between patients treated with cisplatin plus either docetaxel or paclitaxel [ 15 ].
This undoubtedly is due in a large part to patient selection. J Clin Oncol ; 8: Preferences for chemotherapy in patients with advanced ecg lung cancer: In the pairwise comparison of DC versus VC, the overall survival times were Randomised trials of chemotherapy plus supportive care versus supportive care alone in advanced NSCLC. Have we made any progress in the treatment of advanced non-small cell lung cancer NSCLC over the past 15 years? To Recreate Risk Factors and Prognosis?
Identify key efficacy findings from the four large randomized trials assessing platinum-taxane combinations in advanced NSCLC. The original sample size was significantly larger, but the trial was stopped early when the interim analysis showed a significant benefit to the experimental arm in terms of improved overall survival.
Moreover, the median and 1-year survival rates in patients treated with second-line docetaxel were superior to those achieved with best supportive care, and those benefits were achieved in eocg with a positive impact on QOL [ 418 ].
Taxanes in lung cancer: Disappointingly, data about QoL are scanty. The remainder of toxicity was well balanced between all three groups, with the exception of more diarrhea in the antibody arms. Cremophor EL-mediated alteration of paclitaxel distribution in human blood: Toxicity was a major concern in this trial. Responses Submit a response No responses published.
J Natl Cancer Inst. Although a trend of slightly lower efficacy of combination chemotherapy without platinum is reported in some trials [ 4042 ], none of the trials show a statistically significant advantage for platinum-containing schedules.