Randomized, Multinational, Phase III Study of Docetaxel Plus Platinum Combinations Versus Vinorelbine Plus Cisplatin for Advanced Non–Small-Cell Lung Cancer: The TAX 326 Study Group

American Society of Clinical Oncology (ASCO) - Tập 21 Số 16 - Trang 3016-3024 - 2003
Frank V. Fossella1, José Trigo1, Joachim von Pawel1, A Płużańska1, Vera Gorbounova1, E. Kaukel1, K. Mattson1, Rodryg Ramlau1, Judith Balmañà1, P. Fidias1, Michael Weichenthal1, Chandra P. Belani2,1
1From the M.D. Anderson Cancer Center, Houston, TX; Instituto do Câncer Arnaldo Vieira de Carvalho, Sao Paulo, Brazil; Asklepios Fachkliniken München-Gauting, Gauting, Germany; M. Kopernik Memorial Hospital, Lodz, Poland; Cancer Research Center RAMS, Moscow, Russia; AK-Hamburg-Harbug, Hamburg, Germany; Helsinki University Central Hospital, Helsinki, Finland; Regional Lung Diseases Center, Poznań; Regional Lung Diseases Hospital, Otwock, Poland; Massachusetts General Hospital, Boston, MA; Sydney Cancer...
2Department of Medicine

Tóm tắt

Purpose: To investigate whether docetaxel plus platinum regimens improve survival and affect quality of life (QoL) in advanced non–small-cell lung cancer (NSCLC) compared with vinorelbine plus cisplatin as first-line chemotherapy. Patients and Methods: Patients (n = 1,218) with stage IIIB to IV NSCLC were randomly assigned to receive docetaxel 75 mg/m2 and cisplatin 75 mg/m2 every 3 weeks (DC); docetaxel 75 mg/m2 and carboplatin area under the curve of 6 mg/mL • min every 3 weeks (DCb); or vinorelbine 25 mg/m2/wk and cisplatin 100 mg/m2 every 4 weeks (VC). Results: Patients treated with DC had a median survival of 11.3 v 10.1 months for VC-treated patients (P = .044; hazard ratio, 1.183 [97.2% confidence interval, 0.989 to 1.416]). The 2-year survival rate was 21% for DC-treated patients and 14% for VC-treated patients. Overall response rate was 31.6% for DC-treated patients v 24.5% for VC-treated patients (P = .029). Median survival (9.4 v 9.9 months [for VC]; P = .657; hazard ratio, 1.048 [97.2 confidence interval, 0.877 to 1.253]) and response (23.9%) with DCb were similar to those results for VC. Neutropenia, thrombocytopenia, infection, and febrile neutropenia were similar with all three regimens. Grade 3 to 4 anemia, nausea, and vomiting were more common (P < .01) with VC than with DC or DCb. Patients treated with either docetaxel regimen had consistently improved QoL compared with VC-treated patients, who experienced deterioration in QoL. Conclusion: DC resulted in a more favorable overall response and survival rate than VC. Both DC and DCb were better tolerated and provided patients with consistently improved QoL compared with VC. These findings demonstrate that a docetaxel plus platinum combination is an effective treatment option with a favorable therapeutic index for first-line treatment of advanced or metastatic NSCLC.

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American Society of Clinical Oncology (ASCO)

Tập 21 Số 16

3016-3024

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