More Tolerable Chemotherapy May Be an Option for the Treatment of lung cancer
According to the results of a study recently published in the Journal of Clinical Oncology, the treatment combination of Taxotere® (docetaxel) and Gemzar® (gemcitabine) for patients with non-small cell lung cancer produced fewer side effects than comparable chemotherapy regimens.
Lung cancer is the leading cause of cancer-related deaths in the United States and Europe. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and is a malignancy that arises from the tissues of the lung. Under most circumstances, NSCLC is not curable. Current treatments include surgery, chemotherapy and radiation. Chemotherapy with platinum-based drugs, such as Platinol® (cisplatin) or Paraplatin® (carboplatin), is frequently used to treat NSCLC initially; however, these drugs can be difficult to tolerate due to their side effects.
Researchers in this recent study sought to compare the activity and tolerability of two different chemotherapy regimens: Navelbine® (vinorelbine) and Platinol versus another regimen that contains the drugs Taxotere and Gemzar. There were 413 eligible patients with advanced NSCLC enrolled in the study, none of whom had previously received chemotherapy. Each patient was randomly assigned to receive either Taxotere/Gemzar (197) or Platinol/Navelbine (192). Patients were also treated every 3 weeks with prophylactic doses of a colony-stimulating factor to help prevent a drop in their white blood count.
At the study’s completion, the average survival was 9 months among the group of patients who had received the Taxotere/Gemzar regimen, compared to 9.7 months among the Platinol/Navelbine group. One-year survival rates were 34% for the Taxotere/Gemzar group and 40% in the Platinol/Navelbine group. Overall response rate was 30% and 39%. Side effects such as anemia (low red blood cell counts), low white blood cell counts that resulted in a fever, or low white blood counts without a fever, as well as nausea and vomiting, were all significantly more frequent among the patients who received Platinol/Navelbine when compared to the Taxotere/Gemzar group. In addition, quality-of-life indicators improved in the Taxotere/Gemzar treatment group, but did not improve in the Platinol/Navelbine treatment group. There were five treatment related deaths in the Taxotere/Gemzar group and six in the Platinol/Navelbine group.
Researchers concluded that the two regimens produced comparable overall survival rates; however, the Taxotere/Gemzar regimen was better tolerated than the Platinol/Navelbine regimen. These results indicate that Taxotere/Gemzar could be used as initial treatment for NSCLC, particularly among patients who may not be able to tolerate Platinol.
Reference: Georgoulious F, Ardavanis A, Tsiafaki X, et al. Vinorelbine Plus Cisplatin Versus Docetaxel Plus Gemcitabine in Advanced Non Small Cell Lung Cancer: A Phase III Randomized Trial. Journal of Clinical Oncology. 2005; 23:2937-2945.
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