Analysis of Chemotherapy and Molecular Therapy efficiency in Advanced or Metastatic Non-Small Cell Lung Cancer
Alma Mekic-Abazovic, Hakija Beculic, Senad Dervisevic, Bilal Imcirovic
Med Arh. 2012; 66(4): 262-264
Aim: To compare a benefit of chemiotherapeutic protocols Docetaxel with Tarceva molecular therapy in advanced or metastatic non-small cell lung cancer (NSCLC). Primary endpoint- OS (Overall survival), Toxicity, Secondary endpoint-Quality of life. Patients and methods: In this retrospective and -prospec-tive study a total of 63 patients (two groups- 30+33 patients) were analysed and treated for advanced or metastatic NSCLC during the period 2008-2010. One group was treated with molecular therapy Tarceva oral, and the other group was treated with chemiotherapy Docetaxel monotherapy every three weeks. The chemotherapy was administered intravenously. Monitoring parameters included overall survival and toxicity. Results: Statistical differencet was registered in histology type, total toxicity and total survival. Adenocarcinom occured as a more often pathohistologic type in both groups of patients (Tarceva 57, 6% vs Docetaxel 83, 3%). The chemio-therapeutic protocol, Docetaxel monotherapy, demonstrated higher total toxicity than Tarceva molecular therapy (hematological toxicity grade II 69. 0 % Docetaxel vs 12. 5 % Tarceva). Tarceva molecular therapy demonstrated longer overall survival (OS) than Docetaxel (Tarceva 26, 4 months vs Docetaxel 15, 5 months). Conclusion: In this investigation of two groups of patients the molecular therapy Tarceva was showed better efficiency and toxicity profile. Preferred regimen could be molecular therapy Tarceva.
1. Ginsberg RJ, Vokes EE, Raben A. Non-small cell lung cancer in: Cancer Principles and Practice of Oncology. JR De Vita, S Hellman, SA Rosenberg. JB Lippincot Company, Philadelphia. 1997; 858-911.
2. Lilenbaum R, Herndon J, List M. et all. Single-agent (SA) versus combination chemotherapy (CC) in advanced non-small lung cancer (NSCLC): a CALGB randomized trial of efficacy, quality of life (QoL) and cost-effectiveness. Proc Am Soc Clin Oncol. 2002; 21:1a.
3. Ticzynsky J, Bray F. et all. Lung cancer in Europe. ENCR Cancer Fact Shets. 2002; 1:1-4.
4. Jemal A, Murray T. et all. Cancer statistics, Ca Cancer J Clin. 2003; 53: 5-26.
5. Aberola V, Camps C, Provencia M, Isla D, Rosell R, Vadell C. Cisplatin plus gemcitabine (CG) vs a cisplatin-based triplet vs nonplatinum sequential doublets in advanced non small cell lung cancer (NSCLC): a Spanish Lung Cancer Group phase III randomized trial (GEPC/98–02). J Clin Oncol 2003; 21:3207–13.
6. Baggstrom M, Socinski MA, Hensing T, Poole C. Third generation chemotherapy regimens (3GR) improve survival over second generation regimens (2GR) in stage IIIB/IV non small cell lung cancer (NSCLC): a meta-analysis of the published literature. Proc Am Soc Clin Oncol 2002; 21:306.
7. Depierre A, Chastang C, Quoix E et all. Vinerolbine versus vinorelbine plus cisplatin in advanced non-small lung cancer: a randomised trial. Ann Oncol 1994; 5:37-42.
8. Deza EG, Balbiani L, Coppola F, et al. Phase III study of navelbine (NVB) vs NVB plus cisplatin in non small cell lung cancer (NSCLC) stage IIIB or IV. Proc Am Soc Clin Oncol 1996;15:394 (Abstr 1193).
9. Fukuoka M, Masuda N, et al. A randomised trial in inoperable non small cell lung cancer: vindesine and cisplatine versus mitmycin, vindesin, cisplatin versus etoposide and cisplatin alternating with vindesin and mitomycin. J Clin Oncol 1991; 9:606-613.
10. Kelly K, Crowley J, Bunn P, Presant C, Grevstad P, Moinpour C. Randomized phase III trial of paclitaxel plus carboplatin versus vinorelbine plus cisplatin in the treatment of patients with advanced non small cell lung cancer (NSCLC): a Southwest Oncology Group trial. J Clin Oncol 2001; 19:3210–8.
11. Le Chevalier T, Brisgand D, Soria JC, et al. Long term analysis of survival in the European randomized trial comparing vinorelbine/cisplatin to vindesine/cisplatin and vinorelbine alone in advanced non small cell lung cancer. The Oncologist 2001; 6 (suppl 1):8-11.
12. Yana T, Takada M, Origasa H, Ijima T. Yamamoto N, Nakagawa K,Fukuoka M. New chemotherapy agent plus platinum for advance non small cell lung cancer: a meta-analysis. Pro Am Soc Clin Oncol 2002; 21:328.
13. Wozniak AJ, Crowley JJ, Balcezark SP et al. Randomized trial comparing cisplatin with cisplatin plus vinorelbine in the treatment of advanced non small cell lung cancer (NSCLC): A Southwest Oncology Group study. J Clin Oncol 1998; 16:2459-2465.
14. Scagliotti G, De Marinis F, Rinaldi M, et al. Phase III randomized trial comparing three platinum-based doublets in advanced non small cell lung cancer. J Clin Oncol 2002; 20:4285–91.
15. Kovčin V, Jelić S, Radosavljević D, Babović N, Radulović S. Second line chemotherapy with high-dose of Etoposide and Cisplatin for lung cancer–lack of activity. In:Antypas G, ed Lung Cancer. Monduzzi Editore S.P. A. Ed, Bologna, 1996: 545-9 (In Serbian).