A retrospective analysis of outcomes across histological subgroups in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel versus paclitaxel plus carboplatin for advanced non-small cell lung cancer

Joseph Treat, Martin J. Edelman, Chandra Belani, Mark A. Socinski, Matthew J. Monberg, Ruqin Chen, Coleman K. Obasaju

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: Three phase III trials have shown pemetrexed to be associated with improved clinical outcomes among patients with adenocarcinoma and large cell histology compared with patients with squamous histology in advanced non-small cell lung cancer (NSCLC). The current retrospective analysis examined whether differences were present by histology in a three-arm trial of gemcitabine-carboplatin (GCb) or gemcitabine-paclitaxel (GP) versus a standard regimen of paclitaxel-carboplatin (PCb). Materials and methods: 1135 chemonaïve patients with stage IIIB or IV NSCLC were randomly allocated to receive: gemcitabine 1000mg/m2 days 1 and 8 plus carboplatin area under the curve (AUC) 5.5 day 1 (GCb); or gemcitabine 1000mg/m2 days 1 and 8 plus paclitaxel 200mg/m2 day 1 (GP); or paclitaxel 225mg/m2 plus carboplatin AUC 6.0 day 1 (PCb). Cycles were repeated every 21 days up to 6 cycles or disease progression. Clinical results were retrospectively analyzed in by patient histology. Results: 202 patients (17.8%) had squamous, 555 (48.9%) had adenocarcinoma, 45 (4.0%) had large cell, and 333 (29.3%) had another histologic type. The overall response rate for squamous patients was greater than non-squamous (35.1% versus 27.8%, P=0.04). Median survival (9.5 months for squamous and 8.3 months for non-squamous) and median time to progression (5.0 months for squamous and 4.4 months for non-squamous) did not significantly vary by histologic group. For squamous histology, median survival was 6.6 months for GCb, 10.2 months for GP, and 10.3 months for PCb. For non-squamous disease, median survival was 8.2 months for GCb, 8.4 months for GP, and 8.3 months for PCb. A formal test for a histology-by-treatment interaction effect between GCb and PCb was significant (P=0.04). Conclusion: In this trial of commonly used agents for advanced NSCLC, overall survival and time to progression were similar when comparing patients across histologies. The effect of treatment, however, varied across histologies.

Original languageEnglish (US)
Pages (from-to)340-346
Number of pages7
JournalLung Cancer
Volume70
Issue number3
DOIs
StatePublished - Dec 1 2010

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gemcitabine
Carboplatin
Paclitaxel
Non-Small Cell Lung Carcinoma
Histology
Survival
Area Under Curve
Pemetrexed
Adenocarcinoma

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

@article{553b265b3ae9495e8318f56d4e35174f,
title = "A retrospective analysis of outcomes across histological subgroups in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel versus paclitaxel plus carboplatin for advanced non-small cell lung cancer",
abstract = "Purpose: Three phase III trials have shown pemetrexed to be associated with improved clinical outcomes among patients with adenocarcinoma and large cell histology compared with patients with squamous histology in advanced non-small cell lung cancer (NSCLC). The current retrospective analysis examined whether differences were present by histology in a three-arm trial of gemcitabine-carboplatin (GCb) or gemcitabine-paclitaxel (GP) versus a standard regimen of paclitaxel-carboplatin (PCb). Materials and methods: 1135 chemona{\"i}ve patients with stage IIIB or IV NSCLC were randomly allocated to receive: gemcitabine 1000mg/m2 days 1 and 8 plus carboplatin area under the curve (AUC) 5.5 day 1 (GCb); or gemcitabine 1000mg/m2 days 1 and 8 plus paclitaxel 200mg/m2 day 1 (GP); or paclitaxel 225mg/m2 plus carboplatin AUC 6.0 day 1 (PCb). Cycles were repeated every 21 days up to 6 cycles or disease progression. Clinical results were retrospectively analyzed in by patient histology. Results: 202 patients (17.8{\%}) had squamous, 555 (48.9{\%}) had adenocarcinoma, 45 (4.0{\%}) had large cell, and 333 (29.3{\%}) had another histologic type. The overall response rate for squamous patients was greater than non-squamous (35.1{\%} versus 27.8{\%}, P=0.04). Median survival (9.5 months for squamous and 8.3 months for non-squamous) and median time to progression (5.0 months for squamous and 4.4 months for non-squamous) did not significantly vary by histologic group. For squamous histology, median survival was 6.6 months for GCb, 10.2 months for GP, and 10.3 months for PCb. For non-squamous disease, median survival was 8.2 months for GCb, 8.4 months for GP, and 8.3 months for PCb. A formal test for a histology-by-treatment interaction effect between GCb and PCb was significant (P=0.04). Conclusion: In this trial of commonly used agents for advanced NSCLC, overall survival and time to progression were similar when comparing patients across histologies. The effect of treatment, however, varied across histologies.",
author = "Joseph Treat and Edelman, {Martin J.} and Chandra Belani and Socinski, {Mark A.} and Monberg, {Matthew J.} and Ruqin Chen and Obasaju, {Coleman K.}",
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A retrospective analysis of outcomes across histological subgroups in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel versus paclitaxel plus carboplatin for advanced non-small cell lung cancer. / Treat, Joseph; Edelman, Martin J.; Belani, Chandra; Socinski, Mark A.; Monberg, Matthew J.; Chen, Ruqin; Obasaju, Coleman K.

In: Lung Cancer, Vol. 70, No. 3, 01.12.2010, p. 340-346.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A retrospective analysis of outcomes across histological subgroups in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel versus paclitaxel plus carboplatin for advanced non-small cell lung cancer

AU - Treat, Joseph

AU - Edelman, Martin J.

AU - Belani, Chandra

AU - Socinski, Mark A.

AU - Monberg, Matthew J.

AU - Chen, Ruqin

AU - Obasaju, Coleman K.

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Purpose: Three phase III trials have shown pemetrexed to be associated with improved clinical outcomes among patients with adenocarcinoma and large cell histology compared with patients with squamous histology in advanced non-small cell lung cancer (NSCLC). The current retrospective analysis examined whether differences were present by histology in a three-arm trial of gemcitabine-carboplatin (GCb) or gemcitabine-paclitaxel (GP) versus a standard regimen of paclitaxel-carboplatin (PCb). Materials and methods: 1135 chemonaïve patients with stage IIIB or IV NSCLC were randomly allocated to receive: gemcitabine 1000mg/m2 days 1 and 8 plus carboplatin area under the curve (AUC) 5.5 day 1 (GCb); or gemcitabine 1000mg/m2 days 1 and 8 plus paclitaxel 200mg/m2 day 1 (GP); or paclitaxel 225mg/m2 plus carboplatin AUC 6.0 day 1 (PCb). Cycles were repeated every 21 days up to 6 cycles or disease progression. Clinical results were retrospectively analyzed in by patient histology. Results: 202 patients (17.8%) had squamous, 555 (48.9%) had adenocarcinoma, 45 (4.0%) had large cell, and 333 (29.3%) had another histologic type. The overall response rate for squamous patients was greater than non-squamous (35.1% versus 27.8%, P=0.04). Median survival (9.5 months for squamous and 8.3 months for non-squamous) and median time to progression (5.0 months for squamous and 4.4 months for non-squamous) did not significantly vary by histologic group. For squamous histology, median survival was 6.6 months for GCb, 10.2 months for GP, and 10.3 months for PCb. For non-squamous disease, median survival was 8.2 months for GCb, 8.4 months for GP, and 8.3 months for PCb. A formal test for a histology-by-treatment interaction effect between GCb and PCb was significant (P=0.04). Conclusion: In this trial of commonly used agents for advanced NSCLC, overall survival and time to progression were similar when comparing patients across histologies. The effect of treatment, however, varied across histologies.

AB - Purpose: Three phase III trials have shown pemetrexed to be associated with improved clinical outcomes among patients with adenocarcinoma and large cell histology compared with patients with squamous histology in advanced non-small cell lung cancer (NSCLC). The current retrospective analysis examined whether differences were present by histology in a three-arm trial of gemcitabine-carboplatin (GCb) or gemcitabine-paclitaxel (GP) versus a standard regimen of paclitaxel-carboplatin (PCb). Materials and methods: 1135 chemonaïve patients with stage IIIB or IV NSCLC were randomly allocated to receive: gemcitabine 1000mg/m2 days 1 and 8 plus carboplatin area under the curve (AUC) 5.5 day 1 (GCb); or gemcitabine 1000mg/m2 days 1 and 8 plus paclitaxel 200mg/m2 day 1 (GP); or paclitaxel 225mg/m2 plus carboplatin AUC 6.0 day 1 (PCb). Cycles were repeated every 21 days up to 6 cycles or disease progression. Clinical results were retrospectively analyzed in by patient histology. Results: 202 patients (17.8%) had squamous, 555 (48.9%) had adenocarcinoma, 45 (4.0%) had large cell, and 333 (29.3%) had another histologic type. The overall response rate for squamous patients was greater than non-squamous (35.1% versus 27.8%, P=0.04). Median survival (9.5 months for squamous and 8.3 months for non-squamous) and median time to progression (5.0 months for squamous and 4.4 months for non-squamous) did not significantly vary by histologic group. For squamous histology, median survival was 6.6 months for GCb, 10.2 months for GP, and 10.3 months for PCb. For non-squamous disease, median survival was 8.2 months for GCb, 8.4 months for GP, and 8.3 months for PCb. A formal test for a histology-by-treatment interaction effect between GCb and PCb was significant (P=0.04). Conclusion: In this trial of commonly used agents for advanced NSCLC, overall survival and time to progression were similar when comparing patients across histologies. The effect of treatment, however, varied across histologies.

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JF - Lung Cancer

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