title: The impact of induction chemotherapy on the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer.
abstract: BACKGROUND
  Using data from a large phase III study of previously treated advanced non-small-cell lung cancer (NSCLC) that showed similar efficacy for pemetrexed and docetaxel, this retrospective analysis evaluates the impact of first-line chemotherapy on the outcome of second-line chemotherapy.
  
  
  METHODS
  In all, 571 patients with advanced NSCLC were randomly assigned to receive pemetrexed 500 mg/m(2) or docetaxel 75 mg/m(2) on day 1 of a 21-day cycle. Comparisons were made based on type of first-line therapy [gemcitabine + platinum (GP), taxane + platinum (TP), or other therapies (OT)], response to initial therapy, time since initial therapy, and clinical characteristics. The two second-line treatment groups were pooled for this analysis due to similar efficacy and were assumed to have no interaction with the first-line therapies.
  
  
  RESULTS
  Baseline characteristics were generally balanced. By multivariate analysis, gender, stage at diagnosis, performance status (PS), and best response to first-line therapy significantly influenced overall survival (OS). Additional factors by univariate analysis, histology, and time elapsed from first- to second-line therapy significantly influenced OS.
  
  
  CONCLUSIONS
  Future trials in the second-line setting should stratify patients by gender, stage at diagnosis, PS, and best response to first-line therapy.
authors.affiliation: Division of Medical Oncology, University of Colorado Health Sciences Center, Aurora, CO, USA.
authors.forename: G J
authors.initials: GJ
authors.lastname: Weiss
authors.forename: R
authors.initials: R
authors.lastname: Rosell
authors.forename: F
authors.initials: F
authors.lastname: Fossella
authors.forename: M
authors.initials: M
authors.lastname: Perry
authors.forename: R
authors.initials: R
authors.lastname: Stahel
authors.forename: F
authors.initials: F
authors.lastname: Barata
authors.forename: B
authors.initials: B
authors.lastname: Nguyen
authors.forename: S
authors.initials: S
authors.lastname: Paul
authors.forename: P
authors.initials: P
authors.lastname: McAndrews
authors.forename: N
authors.initials: N
authors.lastname: Hanna
authors.forename: K
authors.initials: K
authors.lastname: Kelly
authors.forename: P A
authors.initials: PA
authors.lastname: Bunn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000077143:Docetaxel; D005260:Female; D005971:Glutamates / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D000068437:Pemetrexed; D016016:Proportional Hazards Models; D012107:Research Design; D012189:Retrospective Studies; D012737:Sex Factors; D043823:Taxoids / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D005971:Glutamates; D043823:Taxoids; D000068437:Pemetrexed; D000077143:Docetaxel; D006147:Guanine