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.
|Published (Last):||9 March 2014|
|PDF File Size:||7.58 Mb|
|ePub File Size:||8.72 Mb|
|Price:||Free* [*Free Regsitration Required]|
Finally, the use of subsequent lines of chemotherapy, which was not reported in the ECOG trial, may have obscured potential differences among the treatments. Randomized trial of paclitaxel plus supportive care versus supportive care for patients with advanced non-small-cell lung cancer.
There were three deaths on study on the irinotecan arm and one death on the etoposide arm. Fear of unacceptable toxicity is one of the major concerns in treatment decisions for PS2 patients and, from this point of view, platinum-free combination chemotherapy deserves attention as it is potentially less 1549 than platinum-based treatment. Of note, docetaxel demonstrated incomplete cross-resistance to paclitaxel in vitro, and clinical data suggest that docetaxel may have activity as second-line therapy in paclitaxel- and platinum-pretreated NSCLC patients [ 17 ].
Nearly all trials showed some ecpg in terms of QoL and symptomatic improvement favouring chemotherapy against supportive care alone, but only one study [ 29 ] specifically analysed QoL in the different PS sub-groups.
The role of adding platinum to third generation single agents in PS2 patients. Disclosure — in the Blink of an Eye. These data should of course be kept in mind when treating PS2 patients, who are at a higher risk of toxicity. Semin Oncol ; 28 suppl 2: Oxford University Press is a department of the University of Oxford. The remainder of toxicity was well balanced between all three groups, with the exception of more diarrhea in the antibody arms. Also, there were differences in treatment delivery between eccog two trials.
A consensus was reached that single-agent ecpg with one of the new agents e.
Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review
Survival determinants in extensive-stage non-small-cell lung cancer: The hazard ratio of survival for combination chemotherapy was 1 when compared with vinorelbine and 0. Initially patients were eligible with performance status PS 0, 1, or 2.
Analysis of adverse events among the four phase III trials also revealed differentiating features. Overall survival was the primary efficacy end point. Lung Cancer ; Participation of patients 65 years of ecoy or older in cancer clinical trials. Results and conclusions of the meeting were presented on 15 and 16 April to about clinical oncologists coming from all over Italy. Ecig for related content. Abstracts from proceedings of the most important oncology meetings, not yet published as full papers, were also considered.
For example, a year-old PS2 patient confined to bed for a painful single bone metastasis is different from an elderly patient confined to bed for a moderate to severe cardiovascular co-morbidity.
Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer.
They represent a significant fcog of the patients that every oncologist has to manage in daily practice, and clinical decision making could be more strongly founded on the results of prospective studies. The primary end point was overall survival, and the study was designed to compare each docetaxel arm with the vinorelbine arm; there was no intention of comparing ecg two docetaxel arms [ 13 ]. The vehicle used for docetaxel is polysorbate, and 1549 pharmacokinetics are dose and schedule dependent [ 7 ].
Therefore, single-agent chemotherapy with these drugs e. Chemotherapeutic management of stage IV non-small cell lung cancer. Columbia University Press ; — Lung cancer mortality in European regions — There were no statistically significant exog differences in QOL at either 13 or 25 weeks. These numbers show that in the last few years there has been a tendency to limit participation in randomised trials to fit patients, excluding PS2 patients. The Japanese study showed an impressive survival advantage to the newer combination.
These findings should not be ignored, especially considering the availability of several drugs characterised by a favourable toxicity profile. Patients treated with cisplatin underwent hydration and received antiemetics. Consensus on clinical research. Study Design and Results A consortium of centers led by Dr.
Although a substantial improvement in overall survival should obviously be the ideal aim of eco 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.
Lung Cancer Highlights
The data with four cycles in these two most recently completed studies are remarkably similar to data using six cycles of therapy, leading Dr. For fcog, the affinity of docetaxel for the tubulin-binding site is twice that of paclitaxel, and docetaxel is twice as efficient as paclitaxel at decreasing the critical tubulin concentration required for the formation of microtubules [ 7 ].
Lung cancer in women: 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: Patient characteristics were reflective of the standard population of patients in advanced lung cancer trials. Notwithstanding the presence of the limitations described above, the panellists aimed for a consensus and to identify priorities for 11594 research because of the clinical relevance of the issue.
Patient and tumor characteristics were similar across treatment groups. Consequently, it is not surprising that the proportion of PS2 patients in population-based studies—not biased by inclusion criteria and not restricted by the characteristics of experimental treatment—is consistently higher than that reported in the majority of clinical trials [ 1011 ].
efog As a result of their single-agent activities and synergistic effects, taxane-platinum combinations are often used as first-line therapy for this disease. From the Cover Conflict of Interest: N Engl J Med.
Baseline characteristics were well balanced across treatment groups. The combination of a taxane with a platinum compound for the first-line therapy of NSCLC has been studied extensively.