title: Chemotherapy outcomes by histologic subtypes of non-small-cell lung cancer: analysis of the southwest oncology group database for antimicrotubule-platinum therapy.
abstract: OBJECTIVE
  Histologic subtyping has been advocated to select chemotherapy for patients with advanced-stage non-small-cell lung cancer (NSCLC). To determine whether histologic subtype was associated with efficacy for the commonly used antimicrotubule (AMT) agents, paclitaxel, docetaxel, and vinorelbine plus a platinum compound, we examined the Southwest Oncology Group (SWOG) lung cancer database.
  
  
  METHODS
  Data from 4 randomized trials (S9308, S9509, S9806, and S0003) administering an AMT agent plus platinum in patients receiving first-line treatment for advanced-stage NSCLC were analyzed. Overall survival (OS) and progression-free survival (PFS) comparisons were performed using Cox proportional hazard regression, adjusting for sex. Median survival times were estimated by Kaplan-Meier.
  
  
  RESULTS
  Of 1146 patients included in this analysis, 640 had adenocarcinoma (56%), 220 had squamous cell carcinoma (19%), 121 had large cell carcinoma (11%), and 165 had NSCLC not otherwise specified (NOS) (14%). Median OS times by histologic subtypes were 8.5, 8.4, 8.2, and 9.6 months, respectively, and median PFS times were 4.2, 4.3, 4.3, and 4.6 months, respectively. No difference in OS or PFS was observed by histologic subtype and, specifically, between nonsquamous and squamous histologies.
  
  
  CONCLUSIONS
  This pooled analysis from 4 SWOG trials using an AMT-platinum regimen did not show a difference in survival outcomes by histologic subtype. Because the majority of patients with advanced NSCLC continue to receive chemotherapy, defining molecular-based predictive markers of responsiveness is warranted.
authors.affiliation: University of California at Davis, Division of Hematology/Oncology, Sacramento, CA. Electronic address: karen.kelly@ucdmc.ucdavis.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Kelly
authors.forename: Kari
authors.initials: K
authors.lastname: Chansky
authors.forename: Philip C
authors.initials: PC
authors.lastname: Mack
authors.forename: Primo N
authors.initials: PN
authors.lastname: Lara
authors.forename: Fred R
authors.initials: FR
authors.lastname: Hirsch
authors.forename: Wilbur A
authors.initials: WA
authors.lastname: Franklin
authors.forename: Antoinette J
authors.initials: AJ
authors.lastname: Wozniak
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Edelman
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Williamson
authors.forename: David R
authors.initials: DR
authors.lastname: Gandara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D054316:Biomarkers, Pharmacological / Q000378:metabolism; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D016208:Databases, Factual; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009859:Oncology Nursing; D017239:Paclitaxel / Q000008:administration & dosage; D017671:Platinum Compounds / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D015206:Southwestern United States; D043823:Taxoids / Q000008:administration & dosage; D050257:Tubulin Modulators / Q000008:administration & dosage; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D054316:Biomarkers, Pharmacological; D017671:Platinum Compounds; D043823:Taxoids; D050257:Tubulin Modulators; D000077143:Docetaxel; D014747:Vinblastine; D017239:Paclitaxel; D000077235:Vinorelbine
keywords: Chemotherapy outcomes; Histology; Lung cancer
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