Weekly docetaxel as second line chemotherapy for advanced non-small-cell lung cancer: Meta-analysis of randomized trials

被引：48

作者：

Bria, Emilio ^{[1
]}

Cuppone, Federica ^{[1
]}

Ciccarese, Mariangela ^{[1
]}

Nistio, Cecilia ^{[1
]}

Facciolo, Francesco ^{[1
]}

Milella, Michele ^{[1
]}

Izzo, Fiorentino ^{[1
]}

Terzoli, Edmondo ^{[1
]}

Cognetti, Francesco ^{[1
]}

Giannarelli, Diana ^{[1
]}

机构：

[1] Regina Elena Inst Canc Res, Dept Med Oncol, I-00144 Rome, Italy

来源：

CANCER TREATMENT REVIEWS | 2006年 / 32卷 / 08期

关键词：

lung cancer; docetaxel; weekly; meta-analysis;

D O I：

10.1016/j.ctrv.2006.07.003

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Docetaxel. has to be considered as the reference control arm for second tine chemotherapy for advanced NSCLC. Weekly docetaxel. has been compared to standard 3-weekly schedule in a randomized fashion to determine if such schedule improves survival and quality of life. We performed a literature-based meta-analysis of all. randomized clinical trials (RCTs) comparing weekty over 3-weekly docetaxel. in advanced NSCLC. Methods: All, randomized trials were considered eligible. A Literature-based meta-analysis was accomplished, and event-based relative risk ratios (RR) with 95% confidence interval (CI) were derived. A fixed- and a random-effect model. according to the inverse variance and the Mantel-Haenszet method were applied. Heterogeneity test was applied as welt. Results: We found six RCTs (three phase III, two phase II, 1018 patients), in which data for overall survival (OS), overall response rate (ORR) and grade 3-4 (G3-4) WHO neutropenia were available. When considering only phase III RCTs, OS did not significantly differ between the two arms (RR 1.01, 95% CI 0.76, 1.42, p = 0.785) with no significant heterogeneity (p = 0.42). Regarding activity, no significant differences in favour of weekly docetaxel were found, although a trend for 3-weekly schedule was observed (RR 0.81, 95% CI 0.47, 1.40, p = 0.485), with no significant heterogeneity (p = 0.27). No differences were found in the overall population also considering the phase II trials. Regarding G3-4 neutropenia, a significant homogenous advantage in favour of weekly docetaxet was found, with an absolute benefit of 15-19%. Conclusions: Although considering all drawbacks related to literature- based meta-analyses, weekly docetaxel seems not to improve survival when compared to 3-weekly docetaxel. The significant benefit in grade 3-4 neutropenia seems to suggest this approach in patients with NSCLC pretreated for advanced disease. The quality of life of both schedules needs to be evaluated in an individual patient data meta-anatysis. (c) 2006 Elsevier Ltd. All rights reserved.

引用

页码：583 / 587

页数：5

共 18 条

[1] Confidence intervals for the number needed to treat [J].

Altman, DG .

BRITISH MEDICAL JOURNAL, 1998, 317 (7168) :1309-1312

[2] Second-line treatment for advanced non-small cell lung cancer:: A systematic review [J].

Barlési, F ;

Jacot, W ;

Astoul, P ;

Pujol, JL .

LUNG CANCER, 2006, 51 (02) :159-172

[3] Survival improvement in resectable non-small cell lung cancer with (neo) adjuvant chemotherapy: results of a meta-analysis of the literature. by Berghmans T., et al. [Lung Cancer 49 (2005) 13-23] - Reply [J].

Berghmans, T ;

Sculier, JR ;

Paesmans, M .

LUNG CANCER, 2006, 51 (02) :263-265

[4] Survival improvement in resectable non-small cell lung cancer with (neo)adjuvant chemotherapy: Results of a meta-analysis of the literature [J].

Berghmans, T ;

Paesmans, M ;

Meert, AP ;

Mascaux, C ;

Lothaire, P ;

Lafitte, JJ ;

Sculier, JP .

LUNG CANCER, 2005, 49 (01) :13-23

[5] Benefit of taxanes as adjuvant chemotherapy for early breast cancer - Pooled analysis of 15,500 patients [J].

Bria, Emilio ;

Nistico, Cecilia ;

Cuppone, Federica ;

Carlini, Paolo ;

Ciccarese, Mariangela ;

Milella, Michele ;

Natoli, Guido ;

Terzoli, Edmondo ;

Cognetti, Francesco ;

Giannarelli, Diana .

CANCER, 2006, 106 (11) :2337-2344

[6] Randomized phase III study of 3-weekly versus weekly docetaxel in pretreated advanced non-small-cell lung cancer:: a Spanish Lung Cancer Group trial [J].

Camps, C ;

Massuti, B ;

Jiménez, A ;

Maestu, I ;

Gómez, RG ;

Isla, D ;

González, JL ;

Almenar, D ;

Blasco, A ;

Rosell, R ;

Carrato, A ;

Viñolas, N ;

Batista, N ;

Girón, CG ;

Galán, A ;

López, M ;

Blanco, R ;

Provencio, M ;

Diz, P ;

Felip, E .

ANNALS OF ONCOLOGY, 2006, 17 (03) :467-472

[7] A randomized trial of different docetaxel schedules in non-small cell lung cancer patients who failed previous platinum-based chemotherapy [J].

Chen, YM ;

Shih, JF ;

Perng, RP ;

Tsai, CM ;

Whang-Peng, J .

CHEST, 2006, 129 (04) :1031-1038

[8]

DOUGLASCASE L, 2002, ONCOLOGIST, V7, P181

[9] Randomized phase III trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small-cell lung cancer previously treated with platinum-containing chemotherapy regimens [J].

Fossella, FV ;

DeVore, R ;

Kerr, RN ;

Crawford, J ;

Natale, RR ;

Dunphy, F ;

Kalman, L ;

Miller, V ;

Lee, JS ;

Moore, M ;

Gandara, D ;

Karp, D ;

Vokes, E ;

Kris, M ;

Kim, Y ;

Gamza, F ;

Hammershaimb, L .

JOURNAL OF CLINICAL ONCOLOGY, 2000, 18 (12) :2354-2362

[10] Phase II randomised trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC) [J].

Gervais, R ;

Ducolone, A ;

Breton, JL ;

Braun, D ;

Lebeau, B ;

Vaylet, F ;

Debieuvre, D ;

Pujol, JL ;

Tredaniel, J ;

Clouet, P ;

Quoix, E .

ANNALS OF ONCOLOGY, 2005, 16 (01) :90-96

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