Phase III trial of gemcitabine plus carboplatin versus single-agent gemcitabine in the treatment of locally advanced or metastatic non-small-cell lung cancer: The Swedish Lung Cancer Study Group
2005 (English)In: Journal of Clinical Oncology, ISSN 0732-183X, Vol. 23, no 33, 8380-8388 p.Article in journal (Refereed) Published
Purpose: This phase III study compared overall survival in patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) when treated with single-agent gemcitabine versus gemcitabine/carboplatin. Secondary objectives were to compare response, time to progression, toxicity, and quality of life. Patients and Methods: Chemotherapy-naive patients received either gemcitabine alone (1,250 mg/m2 on days 1 and 8, gemcitabine arm) or with carboplatin (area under the curve 5 on day 1, GC arm) every 21 days. Results: Demographics and disease characteristics of 334 randomly assigned patients were comparable on both arms. An intent-to-treat analysis showed significantly better overall survival (log-rank P = .0205) and 2-year survival (15% v 5%, P = .009) favoring the GC arm. Per Cox multivariate analysis, only two covariates, treatment arm (GC v G) and baseline performance status (0 or 1 v 2), independently influenced survival. Per-protocol analyses showed significantly longer median time to progression (5.7 v 3.9 months, P = .0001) and significantly higher objective response rate (29.6 v 11.3%, P < .0001) in the GC arm. Grade 3 to 4 leucopenia and thrombocytopenia were significantly more pronounced in the GC arm (P for both variables < .001) but importantly without associated increases in fever, infection, bleeding, or hospitalizations. There was no discernible difference in global quality-of-life patterns between treatment arms. Conclusion: In advanced NSCLC, gemcitabine/carboplatin therapy resulted in significant survival benefit compared with single-agent gemcitabine without undue increase in toxicity. © 2005 by American Society of Clinical Oncology.
Place, publisher, year, edition, pages
2005. Vol. 23, no 33, 8380-8388 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-50351DOI: 10.1200/JCO.2005.01.2781OAI: oai:DiVA.org:liu-50351DiVA: diva2:271247