Efficacy, toxicity and cost analysis for non-platinum triplet (gemcitabine and vinorelbine, followed by docetaxel) vs. platinum-based chemotherapy in IIIB/IV non-small-cell lung cancer: single-institution experience.
A new non-platinum sequential triplet combination chemotherapy regimen, comprising gemcitabine (1000 mg/m(2)) and vinorelbine (25 mg/m(2)), followed by docetaxel (60 mg/m(2)), was compared in terms of efficacy, toxicity and cost with platinum-based chemotherapy regimens (comprising cisplatin plus one or more other anti-tumour drugs) for the treatment of advanced non-small-cell lung cancer in a matched, small-sample size, case-control study. Patients were selected from a single institution. Patients in the platinum and non-platinum groups were matched for clinical stage (IIIB/IV), performance status (0/1), age and sex. For the non-platinum and platinum groups, the overall response rates were 40% and 47%, and the median survival times were 14 and 14.5 months respectively. The most common grade 3-4 toxicity was neutropenia (27%) in the non-platinum group and nausea/vomiting (67%) in the platinum group. The total treatment cost did not differ significantly between the two groups. The non-platinum sequential triplet combination chemotherapy regimen studied was shown to be as effective as the traditional cisplatin-based combination chemotherapy regimen, and was associated with less toxicity.
Tada
H
H
Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital, Shogoin Kawahara-cho, Sakyo-Ku, Kyoto, Japan. haru.ta@kuhp.kyoto-u.ac.jp
Matsui
S
S
Kawahara
M
M
Hosoe
S
S
Hamada
C
C
Fukushima
M
M
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D016022:Case-Control Studies; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003362:Cost-Benefit Analysis; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077235:Vinorelbine; D000093542:Gemcitabine
D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine; D000093542:Gemcitabine