The chemotherapy combination consisting of paclitaxel and carboplatin is as effective as vinorelbine and cisplatin, but has fewer side effects, according to a recent article published in the Journal of Clinical Oncology.
Approximately 75% of individuals who have lung cancer have a type of cancer referred to as non-small cell lung cancer (NSCLC). Standard treatment options for NSCLC depend on the stage of cancer and may consist of surgery, chemotherapy, radiation and/or biologic therapy (treatment utilizing the immune system to fight cancer). Advanced NSCLC refers to cancer that has spread from its site of origin to distant areas in the body, often including vital organs. One standard initial treatment option for patients with this disease is chemotherapy consisting of vinorelbine plus cisplatin. However, cisplatin is often associated with severe side effects, causing complications in the treatment course for many patients. Therefore, researchers have been evaluating different chemotherapy combinations in an attempt to produce optimal outcomes coupled with fewer side effects.
Researchers from the Southwestern Oncology Group (SWOG) recently conducted a clinical trial comparing vinorelbine and cisplatin to paclitaxel and carboplatin in over 400 patients with advanced NSCLC. The anti-cancer response rate was 28% for patients receiving vinorelbine plus cisplatin and 25% for patients receiving paclitaxel and carboplatin. Survival rates between the two groups were equivalent with the average survival following treatment being 8 months. Overall survival rates one year following treatment are 36% to 38%. Severe lowering of white blood cell counts occurred more often following vinorelbine plus cisplatin compared to paclitaxel and carboplatin. Severe nausea and vomiting also occurred more frequently following vinorelbine plus cisplatin. Peripheral neuropathy (numbness of the extremities) was more frequent after paclitaxel with carboplatin. More patients receiving vinorelbine plus cisplatin discontinued therapy due to side effects.
These results indicate that paclitaxel/carboplatin is equally as efficacious as vinorelbine/cisplatin with fewer side effects for the treatment of advanced NSCLC. Patients with advanced NSCLC may wish to speak with their physician regarding the use of paclitaxel and carboplatin or about the risks and benefits of participating in a clinical trial evaluating other treatment strategies. Two sources of information regarding ongoing clinical trials include comprehensive, easy-to-use listing services provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients. (Journal of Clinical Oncology, Vol 19, No 13, pp 3210-3218, 2001)
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