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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Single-agent chemotherapy should be the standard arm against which experimental treatments are tested in randomised trials dedicated to PS2 patients. One hundred fifty-four patients were randomized between two arms. Crit Rev Oncol Hematol ; To Recreate Risk Factors and Prognosis?

Comparison of survival and quality of life in advanced non-small-cell lung cancer patients treated with two dose levels of paclitaxel combined with cisplatin versus etoposide with cisplatin: For example, 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 ].

The panellists strongly disagree with this approach, which mixes together very different categories, leading to heterogeneous study populations.

None of four chemotherapy regimens offered a significant advantage over the others in the treatment of advanced non-small-cell lung cancer.

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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 15944 13 ] reported that DC was modestly superior to VC, with the median survival being about 1 month longer in patients treated with docetaxel. A consensus was reached that single-agent chemotherapy with one of the new agents e.

Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review

This secondary analysis showed that the significant advantage obtained with the combination of cisplatin and vinorelbine is predominantly limited to fit patients: Proc Am Soc Clin Oncol. 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.


There are several possible reasons for the lower response rates seen in all four arms of this study. Each combination, however, is characterized by a unique adverse-event profile, thus allowing for choices of chemotherapy for the individual patient.

Platinum-based and non-platinum-based chemotherapy in advanced non-small-cell lung cancer: Selected grade 3 or 4 toxicities reported in large phase III clinical trials: Alert me to new issues of The Oncologist. With the aims of reviewing the evidence supporting each of these therapeutic options, possibly reaching a consensus for treatment of PS2 patients affected by advanced NSCLC in clinical practice, and suggesting the priorities for clinical research in this field, an European Experts Panel took place in Avellino, Italy in April The role of chemotherapy in PS2 patients.

Eligible patients had measurable ecof with a good PS. ecoog

High priority should be dedicated to prospective clinical trials evaluating tolerability and efficacy of platinum-based combinations carboplatin-based or low-dose cisplatin-based doubletsas well as to trials testing the new biological target-oriented agents.

Cremophor EL causes pseudo- non-linear pharmacokinetics of paclitaxel in patients. The toxicity associated with this regimen was acceptable.

Prognostic factors for short-term survival in patients with stage IV non-small cell lung cancer. To Recreate Risk Factors and Prognosis?

Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review

Lung Cancer ; In a meta-analysis evaluating the efficacy of chemotherapy in patients with NSCLC 154 12 ], cisplatin-based chemotherapy has shown a slight but statistically significant survival advantage over supportive care.

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 leading cause of cancer-related death in North America. 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 primary analysis of the study showed that the combination was more toxic but it did not show advantage over mono-chemotherapy in terms of efog survival. The end points for these large randomized clinical trials were survival, response rate, adverse events, and quality of life QOL.

Second, given a cytostatic rather than cytotoxic mechanism of action, these agents are more likely to be effective when they are administered ecot rather than in pulses, and oral formulations are preferred for continuous dosing schedules, with obvious logistic advantages for patients. J Clin Pharm Pract ; 3: Toxicity and response criteria of the Eastern Cooperative Oncology Group. Patients with a performance status of 2 had ecoog significantly lower rate of survival than did those with a performance status of 0 or 1.

Lung Cancer Highlights

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European Organization for Research and Treatment of Cancer Nonhematologic toxicities were generally similar between the two groups with the exception of more diarrhea in the irinotecan arm. Dexamethasone was administered to patients receiving docetaxel as prophylaxis against fluid retention and hypersensitivity reactions. In the s, platinum compounds were combined with newer third-generation chemotherapy agents, such as vinorelbine and gemcitabine, and the taxanes docetaxel and paclitaxel.

In fact, patients treated with docetaxel consistently reported improvements in global QOL, while vinorelbine-treated patients consistently reported deteriorating QOL [ 13 ].