Single-agent versus combination chemotherapy in advanced non-small cell lung cancer (NSCLC): A CALGB randomized trial of efficacy, quality of life, and cost-effectiveness

Lilenbaum, Rogerio; Herndon, James E.; List, M.; Desch, Christopher E.; Watson, D.; Holland, J F; Weeks, John D.; Green, M.

doi:10.1016/s0959-8049(01)81051-0

Cited by 91 publications

(67 citation statements)

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“…tin in 584 patients with advanced NSCLC showed a significant advantage in terms of objective response rate (16 vs 30%, P50.0001) and survival distribution (6.5 vs 8.5 months, P=0.023) in favour of combination therapy but no significant difference between treatments in 1-year survival rate (31 vs 36%) (Lilenbaum et al, 2002). Similarly, a comparison of gemcitabine with gemcitabine plus carboplatin in 275 patients with advanced NSCLC showed higher objective response rates (12 vs 30%) and a significantly longer time to progression (4 vs 6 months, P=0.001) with combination therapy; the median survival was 9 months for the whole study population (Sederholm, 2002).…”

Section: Cisplatin and Carboplatinmentioning

confidence: 97%

Platinum drugs in the treatment of non-small-cell lung cancer

Cosaert

Quoix

2002

Br J Cancer

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The use of chemotherapy is considered standard therapy in patients with locally advanced non-small-cell lung cancer that cannot be treated with radiotherapy and in those with metastatic non-small-cell lung cancer and good performance status. This approach is also accepted in patients with earlier stage disease, when combined with radiotherapy in those with nonresectable locally advanced disease, or in the preoperative setting. Randomised clinical studies and meta-analyses of the literature have confirmed the beneficial survival effect of platinum-based chemotherapy. Cisplatin and carboplatin have been successfully used with other drugs in a wide variety of well-established two-drug combinations while three-drug combinations are still under investigation. Cisplatin and carboplatin use is limited by toxicity and inherent resistance. These considerations have prompted research into new platinum agents, such as the trinuclear platinum agent BBR3464, the platinum complex ZD0473 and oxaliplatin. These compounds could be developed in combination with agents such as paclitaxel, gemcitabine or vinorelbine in patients with advanced and/or refractory solid tumours.

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Section: Cisplatin and Carboplatinmentioning

confidence: 97%

Platinum drugs in the treatment of non-small-cell lung cancer

Cosaert

Quoix

2002

Br J Cancer

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“…However, the efficacy of platinum-based chemotherapy has not been evaluated adequately in elderly patients by prospective trials. To date, the only prospectively planned evaluation of platinum-based chemotherapy in elderly patients was conducted in the CALGB 9730 trial 13 . This was a randomized comparison between paclitaxel administered alone or in combination with carboplatin for patients with advanced NSCLC.…”

Section: Discussionmentioning

confidence: 99%

“…However, toxicity was more pronounced with the combination regimen. Because platinum-based doublet regimens are superior to singleagent therapy with either a platinum compound or a novel agent alone [13][14][15][16] , there is a need to evaluate platinumbased combination regimens in elderly patients.…”

Section: Introductionmentioning

confidence: 99%

Weekly Paclitaxel Combined with Carboplatin Versus the Standard Every 3-Weeks Paclitaxel and Carboplatin for Elderly Patients with Previously Untreated Advanced Non-Small Cell Lung Cancer.

El-Shenshawy

Taema

Elzahaf

et al. 2011

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background: Paclitaxel and platinum-based chemotherapy is considered to be a standard approach for locally advanced and metastatic Non-Small Cell Lung Cancer (NSCLC). In recent years, paclitaxel on a weekly schedule in combination with carboplatin has been widely used because it is associated with a lower incidence of neuropathy and myelosuppression. Otherwise, only a few studies are available in elderly patients with NSCLC. Purpose: The aim of our study was to evaluate the efficacy and safety of weekly paclitaxel combined with carboplatin compared with the classic 3-weekly schedule of paclitaxel and carboplatin as initial therapy and the feasibility of subsequent maintenance therapy versus observation in elderly patients with locally advanced ( stage IIIB) and metastatic (stage IV) NSCLC. Patients and Methods: Ninty patients ≥ 65 years with stage IIIB-IV NSCLC were randomly assigned to one of the following arms: arm1, paclitaxel 90 mg/m 2 weekly for 3 of 4 weeks with carboplatin (area under the curve {AUC} =6) on day 1 of each 4 week cycle and arm 2, paclitaxel 200 mg/m 2 with carboplatin (AUC=6) on day 1 of each 3-week. After four cycles of chemotherapy, those with objective response or stable disease were randomized to weekly paclitaxel (70mg/m 2 , 3 of 4 weeks) or observation as maintenance therapy. Primary end point was response while second end points included survival and toxicity. Results: Eighty-six patients were evaluable for response, overall responses were recorded in 42.9% in arm 1 versus 31.8% in arm 2; stable disease was 38.1% in arm 1 versus 27.3% in arm 2 and progressive disease was 19% in arm 1 versus 40.9% in arm 2. The median time to progression and median survival times were 7 months and 10.8 months in arm 1 versus 5.6 months and 9 months in arm 2, respectively. The 1-year survival rates were 47.6% in arm 1 versus 36.4% in arm 2. Grade 3/4 anemia was more common in arm 1 (23.8%) than arm 2 (9.1%). Grade 3/4 neutropenia and febrile neutropenia occurred in 14.3% and 4.7% in arm 1 versus 22.7% and 9.1% in arm 2. Grade 2/3 neuropathy occurred in 4.7 % in arm 1 versus 13.6% in arm 2. Conclusions: Efficacy was similar between the weekly regimen and the standard regimen of carboplatin and paclitaxel for elderly patients with advanced NSCLC and may be advantageous based on its favorable tolerability profile.

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“…The results showed an improvement in Response Rate (RR) and PFS when treated with the combination [7]. Outcomes regarding RR, PFS and OS from a number of phase III retrospective age-specific subgroup analyses showed no significant differences between age groups [8].…”

Section: Single Agent Vs Platinum-based Doubletmentioning

confidence: 97%

Reasonable Choices for Cytotoxic or Cytostatic Treatment in Elderly Advanced Non-Small Cell Lung Cancer Patients

Zarogoulidis¹

2015

Lung Dis Treat

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Single-agent versus combination chemotherapy in advanced non-small cell lung cancer (NSCLC): A CALGB randomized trial of efficacy, quality of life, and cost-effectiveness

Cited by 91 publications

References 0 publications

Platinum drugs in the treatment of non-small-cell lung cancer

Platinum drugs in the treatment of non-small-cell lung cancer

Weekly Paclitaxel Combined with Carboplatin Versus the Standard Every 3-Weeks Paclitaxel and Carboplatin for Elderly Patients with Previously Untreated Advanced Non-Small Cell Lung Cancer.

Reasonable Choices for Cytotoxic or Cytostatic Treatment in Elderly Advanced Non-Small Cell Lung Cancer Patients

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