Comparing Chemotherapy Regimens With Gemcitabine and Cisplatin in Advanced NSCLC
In combination with gemcitabine, carboplatin at AUC6 is not inferior to cisplatin at 80 mg/m2 in terms of survival or quality of life among patients with advanced non–small cell lung cancer (NSCLC), according to the results of a randomized phase III trial published by David Ferry, MD, of the British Thoracic Oncology Group, and colleagues, in the European Journal of Cancer. Moreover, inferior survival without better quality of life was reported for those who received cisplatin at a lower dose of 50 mg/m2.
The three-arm trial assigned 1,363 patients with chemotherapy-naive stage IIIB/IV disease in a 1:1:1 ratio to receive gemcitabine at 1250 mg/m2 on days 1 and 8 of a 3-week cycle with cisplatin at 80 mg/m2, cisplatin at 50 mg/m2, or carboplatin AUC6 for a maximum of 4 cycles.
Survival differed across the three treatment arms, with that for cisplatin at 50 mg/m2 being the worst: median of 8.2 months compared with 9.5 months for cisplatin at 80 mg/m2 and 10.0 months for carboplatin AUC6. The best objective response rates were 29% for those who were treated with the higher dose of cisplatin, 20% for those who were treated with the lower dose of cisplatin, and 27% for those who were treated with carboplatin AUC6, the investigators reported.