Elderly subgroup analysis of a randomized phase III study of docetaxel plus platinum combinations versus vinorelbine plus cisplatin for first-line treatment of advanced nonsmall cell lung carcinoma (TAX 326)

Chandra Belani, Frank Fossella

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129 Citations (Scopus)

Abstract

BACKGROUND. Controversy continues over whether elderly patients with advanced nonsmall cell lung carcinoma (NSCLC) should receive platinum-based chemotherapy. TAX 326 reported improved survival with docetaxel-cisplatin (DC) versus vinorelbine-cisplatin (VC) for advanced NSCLC. DC and docetaxel-carboplatin (DCb) were better tolerated than VC. We analyzed the efficacy and toxicity in patients ages < 65 and > 65 years. METHODS. Chemotherapy- naive, TNM Stage IIIB-IV NSCLC patients were randomized to DC (docetaxel 75 mg/m2 and cisplatin 75 mg/m2, d1 q3w), DCb (docetaxel 75 mg/m2 and carboplatin area under the concentration-time curve 6 mg/mL.min, d1 q3w), or VC (vinorelbine 25 mg/m2, d1, 8, 15, and 22 and cisplatin 100 mg/m2, d1 q4w). RESULTS. Of 1218 patient, 401 were age ≥ 65 years (149/118/134 DC/DCb/VC arms). In the elderly, median survival was 12.6 versus 9.9 months, 1-year survival was 52% versus 41%, 2-year survival was 24% versus 17% for DC versus VC, respectively. DCb survival results were similar to those for VC: median, 9.0 months; 1-year, 38%; 2-year, 19%. Survival outcomes were similar between elderly and younger patients across treatment arms. Compared with younger patients, elderly patients reported moderately higher incidences of NCI CTC (version 1.0) Grade 3-4 asthenia, infection, and pulmonary toxicities across treatment arms, and diarrhea and sensory neurotoxicity for cisplatin-containing arms. Most hematologic toxicities occurred with similar incidences between elderly and younger patients, although neutropenia was slightly increased in elderly patients. CONCLUSION. First-line docetaxel-cisplatin chemotherapy showed similar activity in elderly and younger patients with advanced/metastatic NSCLC; elderly patients tolerated docetaxel-platinum well despite experiencing slightly more toxicity than younger patients.

Original languageEnglish (US)
Pages (from-to)2766-2774
Number of pages9
JournalCancer
Volume104
Issue number12
DOIs
StatePublished - Dec 15 2005

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docetaxel
Platinum
Cisplatin
Carcinoma
Lung
Carboplatin
Therapeutics
Survival
vinorelbine
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

@article{70ba9c33cded4ce48a2ccc97b3e2bb9f,
title = "Elderly subgroup analysis of a randomized phase III study of docetaxel plus platinum combinations versus vinorelbine plus cisplatin for first-line treatment of advanced nonsmall cell lung carcinoma (TAX 326)",
abstract = "BACKGROUND. Controversy continues over whether elderly patients with advanced nonsmall cell lung carcinoma (NSCLC) should receive platinum-based chemotherapy. TAX 326 reported improved survival with docetaxel-cisplatin (DC) versus vinorelbine-cisplatin (VC) for advanced NSCLC. DC and docetaxel-carboplatin (DCb) were better tolerated than VC. We analyzed the efficacy and toxicity in patients ages < 65 and > 65 years. METHODS. Chemotherapy- naive, TNM Stage IIIB-IV NSCLC patients were randomized to DC (docetaxel 75 mg/m2 and cisplatin 75 mg/m2, d1 q3w), DCb (docetaxel 75 mg/m2 and carboplatin area under the concentration-time curve 6 mg/mL.min, d1 q3w), or VC (vinorelbine 25 mg/m2, d1, 8, 15, and 22 and cisplatin 100 mg/m2, d1 q4w). RESULTS. Of 1218 patient, 401 were age ≥ 65 years (149/118/134 DC/DCb/VC arms). In the elderly, median survival was 12.6 versus 9.9 months, 1-year survival was 52{\%} versus 41{\%}, 2-year survival was 24{\%} versus 17{\%} for DC versus VC, respectively. DCb survival results were similar to those for VC: median, 9.0 months; 1-year, 38{\%}; 2-year, 19{\%}. Survival outcomes were similar between elderly and younger patients across treatment arms. Compared with younger patients, elderly patients reported moderately higher incidences of NCI CTC (version 1.0) Grade 3-4 asthenia, infection, and pulmonary toxicities across treatment arms, and diarrhea and sensory neurotoxicity for cisplatin-containing arms. Most hematologic toxicities occurred with similar incidences between elderly and younger patients, although neutropenia was slightly increased in elderly patients. CONCLUSION. First-line docetaxel-cisplatin chemotherapy showed similar activity in elderly and younger patients with advanced/metastatic NSCLC; elderly patients tolerated docetaxel-platinum well despite experiencing slightly more toxicity than younger patients.",
author = "Chandra Belani and Frank Fossella",
year = "2005",
month = "12",
day = "15",
doi = "10.1002/cncr.21495",
language = "English (US)",
volume = "104",
pages = "2766--2774",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "12",

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T1 - Elderly subgroup analysis of a randomized phase III study of docetaxel plus platinum combinations versus vinorelbine plus cisplatin for first-line treatment of advanced nonsmall cell lung carcinoma (TAX 326)

AU - Belani, Chandra

AU - Fossella, Frank

PY - 2005/12/15

Y1 - 2005/12/15

N2 - BACKGROUND. Controversy continues over whether elderly patients with advanced nonsmall cell lung carcinoma (NSCLC) should receive platinum-based chemotherapy. TAX 326 reported improved survival with docetaxel-cisplatin (DC) versus vinorelbine-cisplatin (VC) for advanced NSCLC. DC and docetaxel-carboplatin (DCb) were better tolerated than VC. We analyzed the efficacy and toxicity in patients ages < 65 and > 65 years. METHODS. Chemotherapy- naive, TNM Stage IIIB-IV NSCLC patients were randomized to DC (docetaxel 75 mg/m2 and cisplatin 75 mg/m2, d1 q3w), DCb (docetaxel 75 mg/m2 and carboplatin area under the concentration-time curve 6 mg/mL.min, d1 q3w), or VC (vinorelbine 25 mg/m2, d1, 8, 15, and 22 and cisplatin 100 mg/m2, d1 q4w). RESULTS. Of 1218 patient, 401 were age ≥ 65 years (149/118/134 DC/DCb/VC arms). In the elderly, median survival was 12.6 versus 9.9 months, 1-year survival was 52% versus 41%, 2-year survival was 24% versus 17% for DC versus VC, respectively. DCb survival results were similar to those for VC: median, 9.0 months; 1-year, 38%; 2-year, 19%. Survival outcomes were similar between elderly and younger patients across treatment arms. Compared with younger patients, elderly patients reported moderately higher incidences of NCI CTC (version 1.0) Grade 3-4 asthenia, infection, and pulmonary toxicities across treatment arms, and diarrhea and sensory neurotoxicity for cisplatin-containing arms. Most hematologic toxicities occurred with similar incidences between elderly and younger patients, although neutropenia was slightly increased in elderly patients. CONCLUSION. First-line docetaxel-cisplatin chemotherapy showed similar activity in elderly and younger patients with advanced/metastatic NSCLC; elderly patients tolerated docetaxel-platinum well despite experiencing slightly more toxicity than younger patients.

AB - BACKGROUND. Controversy continues over whether elderly patients with advanced nonsmall cell lung carcinoma (NSCLC) should receive platinum-based chemotherapy. TAX 326 reported improved survival with docetaxel-cisplatin (DC) versus vinorelbine-cisplatin (VC) for advanced NSCLC. DC and docetaxel-carboplatin (DCb) were better tolerated than VC. We analyzed the efficacy and toxicity in patients ages < 65 and > 65 years. METHODS. Chemotherapy- naive, TNM Stage IIIB-IV NSCLC patients were randomized to DC (docetaxel 75 mg/m2 and cisplatin 75 mg/m2, d1 q3w), DCb (docetaxel 75 mg/m2 and carboplatin area under the concentration-time curve 6 mg/mL.min, d1 q3w), or VC (vinorelbine 25 mg/m2, d1, 8, 15, and 22 and cisplatin 100 mg/m2, d1 q4w). RESULTS. Of 1218 patient, 401 were age ≥ 65 years (149/118/134 DC/DCb/VC arms). In the elderly, median survival was 12.6 versus 9.9 months, 1-year survival was 52% versus 41%, 2-year survival was 24% versus 17% for DC versus VC, respectively. DCb survival results were similar to those for VC: median, 9.0 months; 1-year, 38%; 2-year, 19%. Survival outcomes were similar between elderly and younger patients across treatment arms. Compared with younger patients, elderly patients reported moderately higher incidences of NCI CTC (version 1.0) Grade 3-4 asthenia, infection, and pulmonary toxicities across treatment arms, and diarrhea and sensory neurotoxicity for cisplatin-containing arms. Most hematologic toxicities occurred with similar incidences between elderly and younger patients, although neutropenia was slightly increased in elderly patients. CONCLUSION. First-line docetaxel-cisplatin chemotherapy showed similar activity in elderly and younger patients with advanced/metastatic NSCLC; elderly patients tolerated docetaxel-platinum well despite experiencing slightly more toxicity than younger patients.

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