Journal
JOURNAL OF CLINICAL ONCOLOGY
Volume 19, Issue 13, Pages 3210-3218Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1200/JCO.2001.19.13.3210
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Funding
- NCI NIH HHS [CA38926, CA37981, CA35431, CA35262, CA14028, CA12644, CA35192, CA35178, CA16385, CA20319, CA2243, CA35090, CA32102, CA04920, CA04919, CA96429, CA76448, CA74647, CA68183, CA63850, CA63845, CA12213, CA63844, CA58861, CA5882, CA58686, CA58416, CA58415, CA58348, CA52654, CA46441, CA46368, CA46282, CA46136, CA46113, CA45807, CA45560, CA45461, CA45450, CA45377, CA42777] Funding Source: Medline
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Purpose: This randomized trial was designed to determine whether paclitaxel plus carboplatin (PC) offered a survival advantage over vinorelbine plus cisplatin (VC) for patients with advanced non-small-cell lung cancer. Secondary objectives were to compare toxicity, tolerability, quality of life (QOL), and resource utilization, Patients and Methods: Two hundred two patients received VC (vinorelbine 25 mg/m(2)/wk and cisplatin 100 mg/m(2)/d, day 1 every 28 days) and 206 patients received PC (paclitaxel 225 mg/m(2) over 3 hours with carboplatin area under the curve of 6, day 1 every 21 days). Patients completed QOL questionnaires at baseline, 13 weeks, and 25 weeks. Resource utilization forms were completed at five time points through 24 months. Results: Patient characteristics were similar between the groups. The objective response rate was 28% in the VC arm and 25% in the PC arm. Median survival was 8 months in both arms, with 1-year survival rates of 36% and 38%, respectively. Grade 3 and 4 leukopenia (P = .002) and neutropenia (P =.008) occurred more frequently on the VC arm, Grade 3 nausea and vomiting were higher on the VC arm (P = .001, P = .007), and grade 3 peripheral neuropathy was higher on the PC arm (P < .001). More patients on the VC arm discontinued therapy because of toxicity (P = .001), No difference in QOL was observed. Overall costs on the PC arm were higher than on the VC arm because of drug costs. Conclusion: PC is equally efficacious as VC for the treatment of advanced non-small-cell lung cancer. PC is less toxic and better tolerated but more expensive than VC. New treatment strategies should be pursued. (C) 2001 by American Society of Clinical Oncology.
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