"While advanced lung cancer remains incurable, this study provides additional evidence that paclitaxel- and carboplatin-based regimens can prolong survival of patients with this disease," said John Hainsworth, MD, lead study author and Director of Clinical Research at the Sarah Cannon Cancer Center. "Survival beyond two years has been uncommon with previous treatments for advanced non-small cell lung cancer. With these newer regimens, two-year survival is similar to what we used to see at one year with the best supportive care or older regimens."
This study provides long-term follow-up on 321 patients with newly-diagnosed stage IIIB or IV non-small cell lung cancer who were treated in one of three sequential phase II trials between March 1995 and April 1998. All three trials were conducted in The Minnie Pearl Cancer Research Network, a community-based clinical trials group. Each trial included a different treatment regimen: paclitaxel and carboplatin; paclitaxel, carboplatin and gemcitabine; and paclitaxel, carboplatin, and vinorelbine. Data from these trials were compared retrospectively to previous studies on supportive care or traditional cisplatin-based regimens.
After an average follow-up of 58 months, actual one-, two-, and three-year survival rates were 40 percent, 19 percent, and 7 percent, respectively. The actuarial four-year survival rate for the entire group was four percent.
When compared retrospectively to older cisplatin-based regimens (not containing a taxane), these paclitaxel- and carboplatin-based treatments increase one-year survival from 25 to 30 percent, to 35 to 40 percent. These regimens also improve survival substantially when compared to the 16 percent one-year survival rate with supportive care alone.
To date, there has been limited information on long-term survival with any of the newer regimens for patients with advanced non-small cell lung cancer. Most studies examining these regimens are reported with follow-up of 24 months or less.
This study was also consistent with other recent reports in finding that the three-drug regimens were slightly more toxic and did not appear to provide any additional benefits. Patients on the three-drug regimens required more hospitalizations for fever and neutropenia, and experienced more toxicity due to myelosuppression.
"Long-Term Follow-Up of Patients Treated With Paclitaxel/Carboplatin-Based Chemotherapy for Advanced Non-Small-Cell Lung Cancer: Sequential Phase II Trials of the Minnie Pearl Cancer Research Network." John D. Hainsworth, M.D., et al.; Sarah Cannon Cancer Center, Nashville, TN. Vol 20, No 13 (July 1) 2002, pp: 2937-2942.
The Journal of Clinical Oncology is the semi-monthly peer-reviewed journal of the American Society of Clinical Oncology (ASCO), the world's leading professional society representing physicians who treat people with cancer.
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