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According to a recent article published in the Annals of Oncology, the chemotherapy combination consisting of Taxotere® (docetaxel) and Gemzar® (gemcitabine) is as effective as, and better tolerated than the standard chemotherapy combination consisting of cisplatin (Platinol®) and vinorelbine (Velban®) in the treatment of advanced non-small cell lung (NSCLC) cancer.

Lung cancer is the leading cause of cancer-related deaths in the United States and Europe. NSCLC is the most common type of lung cancer and is a malignancy that arises from the tissues of the lung. Metastatic NSCLC refers to NSCLC that has spread from the lung to distant sites in the body. The mainstay of standard treatment for metastatic NSCLC is chemotherapy, either in combination or as a single agent. The targeted agent Tarceva™ (erlotinib) has also been recently approved and is gaining acceptance in the treatment of advanced NSCLC. Chemotherapy combinations including the platinum agent Platinol® are commonly used in the treatment of NSCLC; however, Platinol® is often difficult for patients to tolerate as it is associated with serious side effects that greatly reduce the quality of life of patients. Therefore, researchers have been evaluating other chemotherapy combinations for NSCLC in an attempt to maintain effectiveness while reducing side effects associated with Platinol®. Taxotere® and Gemzar® is a combination that has demonstrated effectiveness in previous trials, and has recently undergone the last phase of clinical trials.

Researchers from France recently conducted a clinical trial directly comparing Taxotere®/Gemzar® to Platinol®/vinorelbine in the treatment of metastatic NSCLC. This trial included 311 patients who had not received prior therapy. Outcomes did not differ significantly between the two groups, including survival, response to treatment, and progression-free survival. Overall survival was 11.1 months for patients treated with Taxotere®/Gemzar®, and 9.6 months for those treated with Platinol®/vinorelbine. Survival at 1 year was 47% for patients treated with Taxotere®/Gemzar®, and 42% for those treated with Platinol®/vinorelbine. Progression-free survival was approximately 4 months for both groups of patients.

However, the group of patients treated with Platinol®/vinorelbine experienced a higher number of serious side effects that were associated with therapy, and were less able to receive full doses of treatment on time due to side effects. Incidences of low levels of blood cells, vomiting and low levels of immune cells associated with a fever were more common in patients treated with Platinol®/vinorelbine, while fluid retention and side effects affecting the lungs were more common in patients treated with Taxotere®/Gemzar®.

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The researchers concluded that the chemotherapy combination consisting of Taxotere® and Gemzar® provides an effective and well tolerated alternative to a Platinol®-based chemotherapy regimen for the treatment of advanced NSCLC. Patients with advanced NSCLC may wish to speak with their physician about their individual risks and benefits associated with different treatment regimens.

Reference: Pujol J-L, Breton J-L, Gervais R, et al. Gemcitabine–docetaxel versus cisplatin–vinorelbine in advanced or metastatic non-small-cell lung cancer: a phase III study addressing the case for cisplatin. Annals of Oncology. 2005; 16:602-610.

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