Meta-analysis of docetaxel-based doublet versus docetaxel alone as second-line treatment for advanced non-small-cell lung cancer

Purpose To compare docetaxel-based doublet with single-agent docetaxel as second-line treatment in non-small-cell lung cancer (NSCLC). Methods We systematically searched for randomized clinical trials that compared docetaxel-based doublet with single-agent docetaxel in patients with histologically proven non-small-cell lung cancer. The primary end point was overall survival (OS). Secondary end points were progression-free survival, overall response rate, 1-year survival rate, and grade 3 or 4 toxicity. Data were extracted from the studies by two independent reviewers. The meta-analysis was performed by Stata version 10.0 software (Stata Corporation, College Station, TX, USA). Results Eight randomized clinical trials (totally 2,126 patients) were eligible. Meta-analysis showed that there was significant improvement in PFS (HR 0.81, 95% CI 0.69–0.96, P = 0.013) and overall response rate (OR 1.42, 95% CI 1.13–1.80, P = 0.03) in docetaxel-based doublet group, compared with docetaxel alone, though the pooled HR for overall survival (HR 0.93, 95% CI 0.80–1.07, P = 0.308) showed no significant difference between the two groups. However, there were more incidences of grade 3 or 4 neutropenia (OR 1.2, 95% CI 1.00–1.45, P = 0.05), thrombocytopenia (OR 4.53, 95% CI 1.75–11.75, P = 0.002), and diarrhea (OR 1.78, 95% CI 1.16–2.74, P = 0.008) in docetaxel-based doublet group. With regard to the risk of grade 3 or 4 anemia (OR 1.95, 95% CI 0.62–6.17, P = 0.25), fatigue (OR 1.09, 95% CI 0.75–1.59, P = 0.66), and nausea and vomiting (OR 1.75, 95% CI 0.78–3.91, P = 0.17), there was no significant difference between the two groups. Conclusions This was the first meta-analysis of docetaxel-based doublet versus single-agent docetaxel as second-line therapy in the treatment of non-small-cell lung cancer. The results indicated that docetaxel-based doublet therapy did not gain any benefit in survival but significantly improved PFS and better ORR versus single-agent docetaxel. However, more incidences of grade 3 or 4 neutropenia, thrombocytopenia, and diarrhea were observed in docetaxel-based doublet group..

Medienart:

E-Artikel

Erscheinungsjahr:

2011

Erschienen:

2011

Enthalten in:

Zur Gesamtaufnahme - volume:69

Enthalten in:

Cancer chemotherapy and pharmacology - 69(2011), 1 vom: 24. Mai, Seite 99-106

Sprache:

Englisch

Beteiligte Personen:

Qi, Wei-Xiang [VerfasserIn]
Shen, Zan [VerfasserIn]
Yao, Yang [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Docetaxel
Meta-analysis
Non-small-cell lung cancer
Second-line therapy

RVK:

RVK Klassifikation

Anmerkungen:

© Springer-Verlag 2011

doi:

10.1007/s00280-011-1678-9

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2091746401

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