Do all patients with advanced non-small-cell lung cancer benefit from cisplatin-based combination therapy?

Soria, Jean‐Charles; Brisgand, D.; Chevalier, Thierry Le

doi:10.1023/a:1013574413217

Cited by 62 publications

(21 citation statements)

References 17 publications

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“…The four independent poor factors that were identified in the initial characteristics of the present patients were male sex, anaemia, weight loss and poor Karnofsky PS. This is in accordance with the present authors' previous trials, and with the studies specifically performed on poor PS [18,19] but does not imply that patients do not benefit from chemotherapy. An overall survival improvement with chemotherapy versus supportive care alone in patients with poor PS has been shown by the Nonsmall Cell Lung Cancer Collaborative Group meta-analysis [20].…”

Section: Chemotherapy For Low Ps Nsclc Patients Jp Sculier Et Alsupporting

confidence: 93%

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Chemotherapy improves low performance status lung cancer patients

Sculier

Lafitte²,

Paesmans³

et al. 2007

Eur Respir J

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The aim of the present study was to determine the potential benefit of conventional cisplatin-based chemotherapy on patients with advanced nonsmall cell lung cancer (NSCLC) and poor performance status (PS), defined as 60-70 on the Karnofsky scale.Retrospective analysis was carried out of a randomised trial performed in advanced NSCLC where 485 patients received three courses of gemcitabine+ifosfamide+cisplatin induction chemotherapy.Of the patients, 80% had good PS (Karnofsky 80-100) and 20% poor PS. Response rates were 38 and 28%, respectively. Clinical improvement, defined as achieving a good PS during chemotherapy, was observed overall in 25% of the poor PS patients, with rates of 38, 20 and 14%, respectively, in case of response, no change and progression. PS improved more quickly in the responders. Survival of patients with poor PS was significantly worse, but survival of responders was similar, irrespective of the initial poor or good PS. Although nonfatal toxicity was almost similar, there were more toxic deaths (including vascular and cardiac fatalities) in the poor PS patients (9.2 versus 2.1%).In conclusion, combination chemotherapy is associated with clinical improvement in a substantial number of patients with advanced nonsmall cell lung cancer of poor performance status.

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Section: Chemotherapy For Low Ps Nsclc Patients Jp Sculier Et Alsupporting

confidence: 93%

“…Patients with poor PS represented 20% of the patients registered in the present trial, a prevalence similar to that reported in other studies [9,18,19,21]. Responses were not observed much less frequently in those patients than in those of good PS.…”

Section: Chemotherapy For Low Ps Nsclc Patients Jp Sculier Et Alsupporting

confidence: 89%

Chemotherapy improves low performance status lung cancer patients

Sculier

Lafitte²,

Paesmans³

et al. 2007

Eur Respir J

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“…Indeed, such combinations may be an option for patients unable to tolerate platinum agents or those with compromised performance status. In addition, patients with a performance status of 2 do not benefit from platinum-based chemotherapy (Soria et al, 2001). In general, studies comparing non-platinum regimens with platinum-based regimens are still ongoing.…”

Section: Other Chemotherapy Optionsmentioning

confidence: 99%

Platinum drugs in the treatment of non-small-cell lung cancer

Cosaert

Quoix

2002

Br J Cancer

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The use of chemotherapy is considered standard therapy in patients with locally advanced non-small-cell lung cancer that cannot be treated with radiotherapy and in those with metastatic non-small-cell lung cancer and good performance status. This approach is also accepted in patients with earlier stage disease, when combined with radiotherapy in those with nonresectable locally advanced disease, or in the preoperative setting. Randomised clinical studies and meta-analyses of the literature have confirmed the beneficial survival effect of platinum-based chemotherapy. Cisplatin and carboplatin have been successfully used with other drugs in a wide variety of well-established two-drug combinations while three-drug combinations are still under investigation. Cisplatin and carboplatin use is limited by toxicity and inherent resistance. These considerations have prompted research into new platinum agents, such as the trinuclear platinum agent BBR3464, the platinum complex ZD0473 and oxaliplatin. These compounds could be developed in combination with agents such as paclitaxel, gemcitabine or vinorelbine in patients with advanced and/or refractory solid tumours.

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“…Advanced NSCLC patients also with poor performance status (PS) tend to have worse response rates and higher risk of toxicities following chemotherapy treatment. 4,5 Intracellular signaling activated by the EGFR plays a role in tumor growth and progression in cancer and EGFR overexpression is seen in up to 80% of NSCLC6,7. Erlotinib is a potent, orally active, reversible inhibitor of EGFR tyrosine-kinase activity and have received approval for the treatment of advanced NSCLC worldwide.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Erlotinib in Previously Treated Advanced Non-Small Cell Lung Cancer

Karaca¹

2013

UHOD

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Erlotinib is a potent inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase, with single-agent antitumor activity which improves symptom control and quality of life compared with placebo in non-small-cell-lung cancer (NSCLC) patients. We aimed to determine the efficacy and safety of the second, third or fourth-line erlotinib in advanced NSCLC patients in Turkish population. Eighty patients (33 males and 47 females) were retrospectively evaluated. All patients had received a platinum-based regimen as the first-line metastatic therapy. Most of the patients (62.5%) had received erlotinib as the second-line treatment. None of the patients had EGFR mutation studied. One patient achieved a complete response, 10 patients partial response and 21 stable diseases. The overall response rate was 14% and disease control rate was 40%. The median progression-free survival (PFS) and overall survival (OS) were 12 months and 18 months, respectively. Although, there was no survival difference between male and female patients, the median PFS of females was significantly better than male patients (p=0.03). There was no significant difference in disease control rate in terms of age, smoking status, erlotinib line, performance status (PS), stage and skin rash. The most common adverse events were skin rash (56%), diarrhea (9%) and anorexia (8%). Sixteen patients (20%) developed grade 3 toxicities. Grade 4 toxicity or treatment related interstitial lung disease were not observed. Erlotinib showed an acceptable response rate, survival time and toxicity after disease progression with chemotherapy. It's an alternative therapy as a second or third-line therapy in patients with NSCLC. Prospective studies are needed to evaluate the efficiency of the treatment in Turkish population. Keywords:Non-small-cell lung cancer, Targeted therapy, Erlotinib, Epidermal growth factor receptor ÖZET Daha Önce Tedavi Edilmifl ‹leri Evre Küçük Hücreli D›fl› Akci¤er Kanserli Hastalarda Erlotinibin Güvenlik ve Etkinli¤iErlotinib tek bafl›na anti-tümör aktiviteye sahip olan güçlü bir epidermal büyüme faktör reseptörü tirozin kinaz inhibitörüdür ve küçük hücreli d›fl› akci¤er kanseri hastalar›nda plasebo ile karfl›laflt›r›ld›¤›nda semptom kontrolü ve yaflam kalitesini iyilefltirmektedir. Çal›fl-mam›zda, Türk popülasyonunda, ileri evre NSCLC hastalar›nda ikinci, üçüncü veya dördüncü s›ra erlotinib tedavisinin etkinlik ve gü-venirlili¤ini retrospektif olarak de¤erlendirmeyi amaçlad›k.

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Do all patients with advanced non-small-cell lung cancer benefit from cisplatin-based combination therapy?

Abstract: PS 2 patients with advanced NSCLC might not benefit from cisplatin combination therapy.

Cited by 62 publications

References 17 publications

Chemotherapy improves low performance status lung cancer patients

Chemotherapy improves low performance status lung cancer patients

Platinum drugs in the treatment of non-small-cell lung cancer

Efficacy and Safety of Erlotinib in Previously Treated Advanced Non-Small Cell Lung Cancer

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