ECOG randomized patients with advanced NSCLC to 1 of 4 new 3 of the 4 regimens used in ECOG docetaxel/cisplatin, paclitaxel/cisplatin. In the ECOG trial, the only direct comparison of similar regimens, response rates and survival times were similar between patients treated with cisplatin. ECOG was chosen as a plenary session presentation because it is an important trial that reflects the state of care in of metastatic NSCLC—the.

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Chemotherapy in non-small cell lung cancer: However, the poor outcome in 11594 PS-2 patients resulted in restricting the eligibility to those with PS-0, 1. In vitro cross-resistance and collateral sensitivity in seven resistant small-cell lung cancer cell lines: Overall survival will continue to be the most reliable measure of treatment efficacy in NSCLC trials.

Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review

These data should of course be kept in mind when treating PS2 patients, who are at a higher risk of toxicity. Platinum-based combination ecof is currently recommended as the standard treatment for patients with advanced non-small-cell lung cancer Ecoybut its benefit seems limited to fit patients with a performance status PS of 0 or 1. There are several possible reasons for the lower response rates seen in all four arms of this study.

The role of non-platinum-based third generation polichemotherapy in PS2 patients. These are important studies to compare because they were conducted at nearly the same time and in very similar though not identical patient populations.

Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. There were no significant differences in terms of response, median survival or one-year survival.


The end points for these large randomized clinical trials were survival, response rate, adverse events, and quality of life QOL. Phase III randomized trial comparing three platinum-based doublets in advanced non-small-cell lung cancer. Toxicity was a major concern in this trial. The JCOG data show a prolongation of survival using irinotecan compared to etoposide when combined with cisplatin.

Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review

The preclinical development of paclitaxel has been primarily performed in the U. Cooperative groups in the United States ecoh now move forward and test novel agents and combinations of novel agents and established chemotherapy in future trials. Six patients treated with chemotherapy plus antibody had life-threatening hemoptysis and four died.

A worse PS is characterised by lower response rates to chemotherapy, shorter time to treatment failure and shorter progression-free survival [ 2728 ]. The finding that second-line therapy of metastatic lung cancer benefits 159 with NSCLC adds to the case for sequential single-agent therapy.

Prognostic factors for survival in patients with inoperable lung cancer. There were no between-group differences in grade 3 or 4 neutropenia, 15944, or infection. However, it seems undeniable that 1549 definition of prognostic sub-groups cannot be made in a subjective fashion and the only way to validate a prognostic score is to encourage and support prospective data collection.

Schiller reported the results of one of the world’s largest randomized trials in metastatic lung cancer comparing four platinum-based doublets. The analysis 1549 toxic deaths showed that only a part of the events were treatment-related and the remaining were secondary, at least in part, to the concomitant diseases often associated with an impaired PS. Nevertheless, PS2 patients had significant benefit from chemotherapy and, with the greater potential for palliation determined by worse baseline condition, showed an improvement in QoL even higher than PS0 and PS1 patients.


Unfortunately, at the time of diagnosis, the majority of patients already have metastatic disease and a systemic, palliative treatment ecogg the only therapeutic option. Nonhematologic toxicities were generally similar between the two groups with the exception of more diarrhea in the irinotecan arm.

The benefits of chemotherapy in patient subgroups with unresectable non-small-cell lung cancer. Chemotherapy for advanced non-small-cell lung cancer: Evaluation of Chemotherapeutic Agents.

5194 A consensus was reached that single-agent chemotherapy with one of the new agents e. Furthermore, the gross categories defined only by PS are inevitably heterogeneous: The Japanese study showed an impressive survival advantage to the newer combination.

L earning O bjectives After completing this course, the reader will be able eecog The relative merits of each of these end points may vary depending on the stages of NSCLC being treated i.

Have we made any progress in the treatment of advanced non-small cell lung cancer NSCLC over the past 15 years? The toxicity associated with this regimen was acceptable. The greatest part of the evidence analysed in the meeting comes from small sub-groups of patients 15594 PS2, enrolled in clinical trials usually including patients with a PS ranging from 0 to 2.

Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer.

After two cycles 194 treatment, the instrument favored PCb versus VC for role functioning, fatigue, nausea and vomiting, and anorexia and favored VC versus PCb for peripheral neuropathy and alopecia. Jpn J Cancer Res. Each combination, however, is characterized by a unique adverse-event profile, thus allowing for choices of chemotherapy for the individual patient.

Pharmacokinetics and pharmacodynamics of the taxanes. N Engl J Med.