title: Phase III randomized trial of docetaxel plus cisplatin versus vindesine plus cisplatin in patients with stage IV non-small-cell lung cancer: the Japanese Taxotere Lung Cancer Study Group.
abstract: OBJECTIVE
  Few randomized trials have demonstrated survival benefit of combination chemotherapy involving new agents plus cisplatin compared with classic combination chemotherapy in advanced non-small-cell lung cancer (NSCLC). The primary aim of this study was to test whether docetaxel plus cisplatin (DC) improves survival compared with vindesine plus cisplatin (VdsC) in patients with previously untreated stage IV NSCLC.
  
  
  METHODS
  Eligible, stage IV, chemotherapy-naive patients (n = 311) were randomly assigned to receive docetaxel 60 mg/m(2) intravenously on day 1 plus cisplatin 80 mg/m(2) intravenously on day 1 of a 3- or 4-week cycle, or vindesine 3 mg/m(2) intravenously on days 1, 8, and 15 plus cisplatin 80 mg/m(2) intravenously on day 1 of a 4-week cycle. Cross-over administration of docetaxel and vindesine was prohibited for both treatment groups.
  
  
  RESULTS
  Overall, 302 patients were eligible for evaluation. The DC arm demonstrated significant improvements compared with the VdsC arm in overall response rates (37% v 21%, respectively; P <.01) and median survival times (11.3 v 9.6 months, respectively; P =.014). Two-year survival rates were 24% for the DC arm compared with 12% for the VdsC arm. The physical domain of the Quality of Life for Cancer Patients Treated with Anticancer Drugs measure was significantly better in the DC arm than in the VdsC arm (P =.020). Toxicity was predominantly hematologic and was more severe in the VdsC arm.
  
  
  CONCLUSIONS
  As first-line treatment for stage IV NSCLC, DC resulted in greater clinical benefit in terms of response rate (with marked improvements in overall and 2-year survival rates) and quality of life than did treatment with VdsC.
authors.affiliation: Thoracic Oncology Division, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. kkubota@east.ncc.go.jp.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kubota
authors.forename: Koshiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Hideo
authors.initials: H
authors.lastname: Kunitoh
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Noda
authors.forename: Yukito
authors.initials: Y
authors.lastname: Ichinose
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Katakami
authors.forename: Takahiko
authors.initials: T
authors.lastname: Sugiura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kawahara
authors.forename: Akira
authors.initials: A
authors.lastname: Yokoyama
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yokota
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yoneda
authors.forename: Kaoru
authors.initials: K
authors.lastname: Matsui
authors.forename: Shinzo
authors.initials: S
authors.lastname: Kudo
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shibuya
authors.forename: Takeshi
authors.initials: T
authors.lastname: Isobe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Segawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nishiwaki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Niitani
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage; D014751:Vindesine / Q000008:administration & dosage
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D014751:Vindesine