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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Results of ECOG Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. Regarding the choice of end points in clinical trials, it should be considered that symptomatic improvement is strongly requested by the patients.
In fact, it has been argued by some that the therapeutic index in advanced disease is too narrow to warrant subjecting patients to the unpleasant side effects of treatment [ 24 ]. This is a very reasonable recommendation. Paclitaxel is a natural product isolated from the Pacific yew, whereas docetaxel is a semisynthetic taxane analogue of the European yew. Columbia University Press ; — Crit Rev Oncol Hematol ; While response rate is a useful surrogate marker, survival is ultimately the best indicator of the success or failure of a treatment.
Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer.
In order to obtain the largest amount of specific information on PS2 patients, some authors were contacted directly by the panel to obtain some data not available from the published papers. The remainder of toxicity was well balanced between all three groups, with the exception of more diarrhea in the antibody arms. With the aims of reviewing the evidence supporting each of these therapeutic options, possibly reaching a consensus for treatment of PS2 patients affected by advanced NSCLC in clinical practice, and suggesting the priorities for clinical research in this field, an European Experts Panel took place in Avellino Italy in April Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer.
Hypersensitivity reactions from taxol.
Lung Cancer Highlights
Prognostic factors for survival in patients with inoperable lung cancer. High priority should be dedicated to prospective clinical trials evaluating tolerability and efficacy of platinum-based combinations carboplatin-based or low-dose cisplatin-based doubletsas well as to trials testing the new biological target-oriented agents.
As for the role of carboplatin, the results of the CALGB study, ecoh paclitaxel plus carboplatin versus paclitaxel alone, must be considered [ 37 ]. Similar to the benefit observed in the sub-group of elderly patients enrolled in the same trial, these results should be interpreted with caution, in view of the substantial risk of selection bias. Clinical practice guidelines for the treatment of unresectable non-small-cell lung cancer.
Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review
Each topic was presented by one of the panellists and, after the discussion, a consensus was reached both for clinical practice suggestions and for clinical research priorities.
Participation of patients 65 years of age or older in cancer clinical trials. Alert me to new issues of The Oncologist.
For this latter sub-group, there is no treatment widely accepted as standard and oncologists have to choose among several treatment options for which PS2 patients are potential candidates: Randomised trials of chemotherapy plus supportive care versus supportive care alone in advanced NSCLC.
Clin Cancer Res ; 4: Because of its low aqueous solubility, the vehicle for paclitaxel is a purified polyoxyethylated castor oil, which eco been implicated in paclitaxel toxicity [ 89 ] and in the nonlinear pharmacokinetics of paclitaxel [ 10 — 12 ]. Another research priority is the improvement of supportive care.
Each combination, however, is characterized by a unique adverse-event profile, thus 5194 for choices of chemotherapy for the individual patient. These are important studies to compare because they were conducted at nearly the same time and in very similar though not identical patient populations. Median age of patients enrolled in randomised clinical trials is often significantly lower than that observed in clinical practice [ 1617 ], and eligibility criteria request good renal, hepatic and cardiac function, as well as absence of other significant co-morbidities.
Consensus on clinical research. Population-based study of 20 cases. The JCOG data show a prolongation of survival using irinotecan compared to etoposide when combined with cisplatin.
Accepted March 22, These results have been confirmed by others [ 20 — 2225 ]. Overall survival will continue to be the most reliable measure of treatment efficacy in NSCLC trials. First, in terms of survival, in the largest prospective phase III study evaluating the efficacy of a taxane-platinum combination in advanced NSCLC, Fossella and colleagues [ 13 ] reported that DC was modestly superior to VC, with the median survival being about 1 month 11594 in patients treated with docetaxel.
A worse PS is characterised by lower response rates to chemotherapy, shorter time to treatment failure and shorter progression-free survival [ 2728 ].