[Docetaxel in combination with cisplatin for first-line treatment of locally advanced or metastatic non-small cell lung cancer: meta-analysis of randomized and controlled clinical trials].
OBJECTIVE
Recent approval of docetaxel in combination with cisplatin (DP) for non-small cell lung cancer (NSCLC) treatment means that an assessment of its effectiveness and toxicity is necessary. The aim of this study was to evaluate docetaxel/cisplatin combination versus other cisplatin-based regimens as the front-line treatment of metastatic or locally advanced NSCLC.


METHODS
We searched randomized and controlled phase III clinical trials comparing DP versus other cisplatin combinations. Patients had to be diagnosed of advanced NSCLC and had not previously received chemotherapy.A meta-analysis was performed using the Mantel-Haenzel method. Antitumoral activity and adverse events were both evaluated. We also made a heterogeneity test and determined the NNT Index (Number Needed to Treat) for two-year survival.


RESULTS
We found three clinical trials that fulfilled our criteria. Results showed significant enhanced two-year survival for DP (11-47% higher than others), but a greater incidence of diarrhea (odds ratio [OR] = 2.525; confidence interval 95% [CI], 1.697-3.756]). Heterogeneity was significant for response, anemia and thrombopenia. NNT was 17 patients for two-year survival.


CONCLUSIONS
DP is a good option in first-line therapy of advanced NSCLC. The two-year survival is significantly longer and its toxic profile similar to other treatments, except for diarrhea.
Sánchez Lerma
Beatriz
B
Servicio de Farmacia, Hospital Universitario Materno-Infantil de Canarias, Las Palmas de Gran Canaria, Spain.
Peñuelas Sánchez
Iván
I
Guillén Grima
Francisco
F
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D000077143:Docetaxel; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin