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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Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer.

Preferences for chemotherapy in patients with advanced non-small-cell lung cancer: For many this will represent a departure from the previous standard of six cycles. First, biological therapies hold the promise of being more selective and less toxic for normal tissues, both in terms of haematological and non-haematological adverse effects.

In addition, patients treated with docetaxel demonstrated improvements in clinical benefit parameters. Chemotherapy for elderly patients with advanced non-small-cell lung cancer: In fact, patients treated with docetaxel consistently reported improvements in global QOL, while vinorelbine-treated patients consistently reported deteriorating QOL [ 13 ].

This Article The Oncologist August vol. N Engl J Med. Analysis of adverse events among the four phase III trials also revealed differentiating features. Although a trend of slightly lower efficacy of combination chemotherapy without platinum is reported in some trials [ 4042 ], none of the trials show a statistically significant advantage for platinum-containing schedules.

Aftersome advantage of chemotherapy versus supportive care alone has been shown not only with platinum-based combination chemotherapy [ 262930 ] but also with many new cytotoxic agents e. Elderly patients have peculiar characteristics related to physiological ageing with progressive reduction of organ functions and are at risk of unexpected and unpredictable toxicity.

Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. The Japanese study showed an impressive survival advantage to the newer combination. Platinum-based chemotherapy is the treatment of choice for patients with non-small cell lung cancer NSCLC.


Performance status as a prognostic factor. Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. Lung cancer is the most common cancer in the world and the leading cause of cancer-related deaths in Europe and in other Western countries [ 1 — 3 ].

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 ].

They represent a significant proportion 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 role of non-platinum-based third generation polichemotherapy in PS2 patients. Clinical practice guidelines for the treatment of unresectable non-small-cell lung cancer.

Weekly paclitaxel, carboplatin, cetuximab, and cetuximab, docetaxel, cisplatin, and fluorouracil, followed by local therapy in previously untreated, locally 15594 head and neck squamous cell carcinoma.

Like topotecan, irinotecan is a topoisomerase I inhibitor with good activity in patients with lung cancer. Moreover, between-group differences in the 2-year survival rates favoring the docetaxel arms were most notable in the TAX trial [ 13 ]. The response rate for all eligible patients was 19 percent, with a median survival of 7.

Treatment with cisplatin and gemcitabine was associated with a significantly longer time to the progression of disease than was treatment with cisplatin and paclitaxel but was more likely to cause grade 3, 4, or 5 renal toxicity in 9 percent of patients, vs. In recent years, the rapidly expanding knowledge of cancer pathogenesis at a molecular level has ceog new targets for drug discovery, and a great number of new anti-cancer drugs have been developed.


This undoubtedly is due in a large part to patient selection. Based on these data, docetaxel was approved in the U. Consensus eog clinical research.

Lung Cancer Highlights

Moreover, it is a widely held opinion that these unfit patients are at higher risk for severe toxicity, which would counterbalance the eventual small benefit expected.

Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: To date, the available data from eckg analyses are few and heterogeneous, and do not allow any type of subclassification.

Overall survival was the primary efficacy end point. The vehicle used for docetaxel is polysorbate, and its pharmacokinetics are dose and schedule dependent [ 7 ].

ECOG registered patients into the initial therapy with etoposide and cisplatin. Patient and tumor characteristics were similar across treatment groups. Patient characteristics were reflective of the standard population of patients in advanced lung cancer trials.

Nonhematologic toxicities were generally similar between the two groups with the exception of more diarrhea in the irinotecan arm. The clinical evaluation of chemotherapeutic agents in cancer. Results and conclusions of the meeting were presented on 15 and 16 April to about clinical oncologists coming from all over Italy. Topotecan is one of most active new agents for SCLC.

Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer.

Each topic was presented by one of the panellists and, after the discussion, a consensus was reached both for clinical practice suggestions and for clinical research priorities. N Engl J Med. Additional differences emerged when QOL data were evaluated.