Paclitaxel plus carboplatin(PC) is the current standard regimen for advanced or metastatic non-small-cell lung cancer (NSCLC) patients. However, paclitaxel is associated with serious toxicity such as peripheral neuropathy.
A tria,l published in October version of the Annals of Oncology, was conducted to see whether there are other regimens that can deliver the same efficacy as Paclitaxel plus carbopltain, but with better tolerability profile.
The study included 1,135 chemonaive patients with stage IIIB or IV NSCLC assigned to receive either 1) paclitaxel plus carboplatin(PC), 2) gemcitabine (Gemzar) plus carboplatin(GC) or 3) gemcitabine (Gemzar) plus paclitaxel(GP).
The results indicated that the alternative treatment regimens (GP and GC) resulted in similar survival (8.5 months for GP and 7.9 months for GC) as the standard treatment (8.7 months for PC). The GP regimen, however, was associated with fewer neutropenia and neuropathy than the standard PC treatment (neutropenia: 20% vs. 34.7% and neuropathy 6.5% vs. 10.9%). Incidence of alopecia did not differ between the GP and the PC regimen (52.7% vs. 52.7%).
Patients who have late stage NSCLC can now consider GP regimen if they are able to tolerate the alopecia side-effect.
Treat JA et. al. Annals of Oncology 21; 540-547, 2010
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