Benefits of Adding a Drug to a Single-Agent or a 2-Agent Chemotherapy Regimen in Advanced Non–Small-Cell Lung Cancer

Delbaldo, Catherine; Michiels, Stefan; Syz, Nathalie; Soria, Jean‐Charles; Chevalier, Thierry Le; Pignon, Jean-Pierre

doi:10.1001/jama.292.4.470

Cited by 322 publications

(188 citation statements)

References 67 publications

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“…Several randomized studies [9 -13], as well as two independent meta-analyses [14,15], have consistently shown that two-drug regimens provide superior response and survival rates compared with monotherapy, whereas threedrug combinations may improve the objective response rate (ORR) but do not yield any survival benefit and are associated with greater toxicity.…”

Section: Introductionmentioning

confidence: 99%

Impact of Third-Generation Drugs on the Activity of First-Line Chemotherapy in Advanced Non-Small Cell Lung Cancer: A Meta-Analytical Approach

Grossi¹,

Aita²,

Defferrari³

et al. 2009

The Oncologist

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Background. The therapeutic equivalence of different third-generation agents in the first-line treatment of advanced non-small cell lung cancer (NSCLC) has long been accepted, although recent studies seem to suggest some superiority of gemcitabine-or docetaxel-containing regimens over other third-generation doublets.Objective. To assess the relative impact of different third-generation drugs on the activity of first-line chemotherapy in advanced non-small cell lung cancer by considering both response and progressive disease (PD) rates as outcome measures.Methods. Published and unpublished data were collected from randomized trials comparing a gemcitabine-, docetaxel-, vinorelbine-or paclitaxel-containing regimen with one or more gemcitabine-, docetaxel-, vinorelbine-or paclitaxel-free combinations. For

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Section: Introductionmentioning

confidence: 99%

Impact of Third-Generation Drugs on the Activity of First-Line Chemotherapy in Advanced Non-Small Cell Lung Cancer: A Meta-Analytical Approach

Grossi¹,

Aita²,

Defferrari³

et al. 2009

The Oncologist

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“…Chemotherapy is a mainstay of treatment in the majority of patients. At present, a twodrug regimen consisting of a platinum agent is regarded standard treatment for adults with good performance status (Delbaldo et al, 2004;Pfister et al, 2004), resulting in an extremely toxic physiologic environment and placing patients at high risk for adverse events. Chemotherapy induced leucopenia (CIL) is a common and significant adverse effect of chemotherapy, defined as a leucopenia count of <4.00×10 9 /L, and it can put patients at risk for severe infection (Lyman et al, 2010;Lyman and Kleiner, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Chemotherapy induced leucopenia (CIL) is a common and significant adverse effect of chemotherapy, defined as a leucopenia count of <4.00×10 9 /L, and it can put patients at risk for severe infection (Lyman et al, 2010;Lyman and Kleiner, 2011). It is also the major dose-limiting toxicity, and it is frequently managed by reducing or delaying the chemotherapy (Delbaldo et al, 2004;Hangaishi, 2011;Saloustros et al, 2011), which can result in lower diseasefree and overall survival (Kvinnsland et al, 1999;Gurney Schiller et al, 2002;Pfister et al, 2004), However, research (Shitara et al, 2011) on breast cancer (Saarto et al, 1997;Poikonen et al, 1999;Cameron et al, 2003;Shitara et al, 2010;Han et al, 2012), small-cell lung cancer (Banerji et al, 2006), osteosarcoma (Ratain, 1998), ovarian cancer (Sawyer and Ratain., 2001) have shown the association between chemotherapy-induced neutropenia and better clinical outcome for patients. It is not associated with increased risk for death (Souza-Dantas et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Association of Chemotherapy-induced Leucopenia with Treatment Outcomes in Advanced Non-small-cell lung Cancer Cases Receiving the NP Regimen

Huang

Liu²,

Liu³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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-242), p=0.009. The differences in RR and TTP were significant. In patients whose CIL kept on 10 days at least, the TTP was significantly prolonged, p=0.0213, and the same was the case for those experiencing grades 1-2 leucopenia and ECOG 0, p=0.0412. Conclusions: Occurrence of CIL correlated with RR and TTP in patients with advanced NSCLC receiving cisplatin and vinorelbine chemotherapy, especially in patients experiencing grades 1-2 leucopenia and ECOG 0, and the same for those with CIL persisting for 10 days at least. CIL could be a biological measure of drug activity and a marker of efficacy.

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“…Non-platinum combinations can also provide modest survival benefits and improvements in quality of life, but these combinations have yet to be broadly accepted (Georgoulias et al, 2005;Treat et al, 2005;Takeda et al, 2009). During the past few years, several novel drugs including paclitaxel, docetaxel, pemetrexed, gemcitabine, vinorelbine, erlotinib, gefitinib have shown significant activity against NSCLC (Shepherd et al, 1993;Walling et al, 1994;Fosella et al, 2000;Smit et al, 2003;Delbaldo et al, 2004;Huang et al, 2008;Kosmidis et al, 2008;Di et al, 2010;Klastersky et al, 2012). As a single agent in advanced NSCLC, gemcitabine has produced response rates of between 20% and 28% and survivals between 7 and 11 months (Anderson et al, 1994;.…”

Section: Introductionmentioning

confidence: 99%

Gemcitabine Plus Paclitaxel as Second-line Chemotherapy in Patients with Advanced Non-Small Cell Lung Cancer

Baykara¹,

Coşkun²,

Berk³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Purpose: The aim of this retrospective study was to determine response rates, progression-free survival (PFS), overall survival (OS) and toxicity of gemcitabine and paclitaxel combinations with advanced or metastatic non-small cell lung cancer patients (NSCLC) who have progressive disease after platinum-based first-line chemotherapy. Methods: We retrospectively evaluated the file records of patients treated with gemcitabine plus paclitaxel in advanced or metastatic NSCLC cases in a second-line setting. The chemotherapy schedule was as follows: gemcitabine 1500 mg/m 2 and paclitaxel 150 mg/m 2 administered every two weeks. Results: Forty-eight patients (45 male, 3 female) were evaluated; stage IIIB/IV 6/42; PS0, 8.3%, PS1, 72.9%, PS2, 18.8%; median age, 56 years old (range 38-76). Six (12.5%) patients showed a partial response (PR), 13 (27.1%) stable disease (SD), and 27 (56.3%) progressive disease (PD). The median OS was 6.63 months (95% CI 4.0-9.2); the median PFS was 2.7 months (95% CI 1.8-3.6). Grade 3 and 4 hematologic toxicities, including neutropenia (n=4, 8.4%), and anemia (n=3, 6.3%) were encountered, but no grade 3 or 4 thrombocytopenia. One patient developed febrile neutropenia. There were no interruption for reasons of toxicity and no exitus related to therapy. Conclusion: The combination of two-weekly gemcitabine plus paclitaxel was an effective and well-tolerated second-line chemotherapy regimen for advanced or metastatic NSCLC patients previously treated with platinum-containing chemotherapy. Although the most common and dose limiting toxicities were neutropenia and neuropathy, this regimen was tolerated well by the patients.

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Benefits of Adding a Drug to a Single-Agent or a 2-Agent Chemotherapy Regimen in Advanced Non–Small-Cell Lung Cancer

Cited by 322 publications

References 67 publications

Impact of Third-Generation Drugs on the Activity of First-Line Chemotherapy in Advanced Non-Small Cell Lung Cancer: A Meta-Analytical Approach

Impact of Third-Generation Drugs on the Activity of First-Line Chemotherapy in Advanced Non-Small Cell Lung Cancer: A Meta-Analytical Approach

Association of Chemotherapy-induced Leucopenia with Treatment Outcomes in Advanced Non-small-cell lung Cancer Cases Receiving the NP Regimen

Gemcitabine Plus Paclitaxel as Second-line Chemotherapy in Patients with Advanced Non-Small Cell Lung Cancer

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