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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J Clin Oncol ; Initially patients were eligible with performance status PS 0, 1, or 2.
Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer.
For PS2 patients, there is no consensus on standard treatment. Overall survival was the primary efficacy end point. User Name Password Sign In. J Clin Oncol ; 9: Selected toxicities from ECOG The median survival of all patients was 9.
An alternative may be found in the use of irinotecan. Platinum-based chemotherapy is the treatment of choice for patients with non-small cell wcog cancer NSCLC. Single-agent versus combination chemotherapy in advanced non-small cell lung cancer: Toxicity was a major concern in this trial. Ceog response rate for all eligible patients was 19 percent, with a median survival of 7. Identify key efficacy findings from the four large randomized trials assessing platinum-taxane combinations in advanced NSCLC.
Lung cancer mortality in European regions — For PS2 patients, grade 3—4 haematological toxicity occurred earlier and more frequently in the arm receiving vinorelbine—cisplatin than in the vinorelbine arm 7 rcog 28 days after the start of treatment, respectively. A consensus was reached that single-agent chemotherapy with one of the new agents e.
Overall survival was a secondary endpoint. Evaluation of Chemotherapeutic Agents. Therefore, single-agent chemotherapy with these drugs e.
A neutropenia, B febrile neutropenia, and C peripheral neuropathy. Services E-mail this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eletters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager.
Semin Oncol ; 28 suppl 2: Etoposide and cisplatin were chosen as the reference arm in this trial. Relevant published papers reporting the results of randomised phase III clinical trials were obtained by Medline search. The discouraging survival, the lower compliance to chemotherapy and the fear of a higher risk of toxicity put a question mark behind chemotherapy administration in this category of patients.
Lung Cancer Highlights
Randomized trial of paclitaxel plus supportive care versus supportive care for patients with advanced non-small-cell lung cancer. As our use of these taxane-platinum combinations expands, these differences in survival, response rate, adverse events, 11594 QOL will permit us to better balance our treatment goals for all patients with all stages of NSCLC.
Patient characteristics for ECOG For NSCLC, novel agents Iressa anti-epidermal growth factor receptor tyrosine kinase and anti-vascular endothelial growth factor monoclonal antibody appear promising. Many of these biological agents are currently being tested, at different degrees of clinical development, in Wcog.
Citing articles via Web of Science Approximately two-thirds of the patients in each treatment group had stage IV disease.
The panellists strongly disagree with this approach, which mixes together very different categories, leading to heterogeneous study populations. The major question is whether toxicity will prohibit further development of this agent. Recent randomised trials of platinum-free versus platinum-based combination chemotherapy in advanced NSCLC. There were differences in patient characteristics between the trials in terms of stage of disease and proportion of patients with brain metastases.
Rcog were stratified by performance status, weight loss, stage and presence of brain metastases. 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 ].
The preclinical development of paclitaxel has been primarily performed in the U. If this is confirmed, this may become the new standard of care for SCLC.
N Engl J Med ; Chemotherapy for advanced non-small-cell lung cancer: In the meta-analysis published inalthough overall results were limited by statistical heterogeneity and evident outcome differences for the different chemotherapy categories, a significant benefit was demonstrated for cisplatin-based trials, and a sub-group analysis confirmed this benefit for both good and poorer PS patients [ 12 ].
Have we made any progress in the treatment of advanced non-small cell lung cancer NSCLC over the past 15 years? How important is response rate?
Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review
Accepted June 29, Different patients may have different benefit, different compliance and different toxicities from the same anti-cancer treatment. Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: Results and conclusions of the meeting were presented on 15 and 16 April to about clinical oncologists coming from all over Italy.
Global cancer statistics in the year In conclusion, docetaxel has markedly impacted the treatment of advanced NSCLC and continued evaluation in earlier-stage disease is warranted.
Moreover, its use as induction therapy for inoperable locally advanced disease is under rigorous investigation, focusing on the optimal integration into current treatment strategies. Patient characteristics were reflective of the standard population of patients in advanced lung cancer trials. Dexamethasone was administered to patients receiving docetaxel as prophylaxis against fluid retention and hypersensitivity reactions. Paclitaxel is a natural product isolated from the Pacific yew, whereas docetaxel is a semisynthetic taxane analogue of the European yew.