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Older Chemotherapy Drug Extends Life Span -- Slightly

European study contradicts earlier findings about lung cancer treatment

THURSDAY, Oct. 10, 2002 (HealthDayNews) -- A study of more than 600 European lung cancer patients found those who took an older chemotherapy drug lived an average of 1.25 months longer than those who took a newer drug.

That new drug is one that's commonly used in the United States.

Those patients who took cisplatin lived an average of 9.8 months, compared to those who took carboplatin and had a survival rate of 8.5 months. Both drugs were taken in combination with paclitaxel, a standard part of lung cancer treatment.

"It was interesting to see that perhaps cisplatin is better than carboplatin in terms of survival," says Dr. Rafael Rosell, an oncologist from Barcelona, Spain. He is lead author of the study, which appears in the October issue of the Annals of Oncology, published by the European Society for Medical Oncology.

"This gain of benefit is not dramatically significant, but it is still not trivial in its scientific results," Rosell says. "People should be fully aware that the benefits could be small but that they know about them."

The findings contradict other studies that found no difference in survival rates among patients who took the different drugs.

In one study, published last January in The New England Journal of Medicine, doctors from the University of Wisconsin found an average survival rate of 7.9 months among all 1,207 patients who took one of four drugs to treat their lung cancers. Two of the drugs were cisplatin and carboplatin.

"None of four chemotherapy regimens offered a significant advantage over the others in the treatment of advanced non-small cell lung cancer," wrote lead author Dr. Joan Schiller.

Rosell acknowledges the contradictory findings.

"We cannot deny there is some refutation to our results, and we have to keep in mind that our data requires further validation," he says.

For the study, Rosell and his colleagues recruited 618 patients, the majority of whom had stage IV lung cancer -- the most advanced form of the disease -- from 42 hospitals in 16 countries. There were five times as many men as women in the study, 511 versus 107. This reflects the fact that many more men than women suffer from lung cancer, Rosell says. The average age of study participants was 58.

Over the course of 15 months, half the patients (302) received paclitaxel/cisplatin and the other half (306) took paclitaxel/carboplatin to treat their lung cancer. Cisplatin has been available to American doctors since its approval in 1978 by the U.S. Food and Drug Administration, while carboplatin, sold by Bristol-Myers under the name Paraplatin, has been on the market since 1998.

During the course of their treatments, the patients were evaluated every six weeks with blood tests, X-rays of their chests to measure tumors, and by their responses to quality-of-life questions. Those questions included information about the side effects of their drugs as well as their emotional and social functioning.

By all these measures, the response rates to the two drugs were similar, Rosell says. The difference was in the slightly longer survival rates.

The one-year survival rate was 38 percent among the cisplatin/paclitaxel patients, compared to a 33 percent survival rate for the carboplatin/paclitaxel group. The two-year survival rate was 15 percent in the first group, compared to 9 percent in the second group.

Rosell says his findings must be seen in context of the poor prognosis for lung cancer patients overall, an opinion echoed in an editorial that accompanied the study. The editorial called for new treatment strategies other than chemotherapy to treat lung cancer.

"But, we are happy to find some difference for the patients and their doctors, a small bit of good news, especially with the seriousness of this disease," he says.

What To Do

Facts about lung cancer are available at Lungcancer.org. The National Institutes of Health has detailed information about cisplatin and carboplatin.

SOURCES: Rafael Rosell, M.D., chief, Medical Oncology Service, Hospital Germans Trias I Pujol, Barcelona, Spain; October 2002 Annals of Oncology; January 2002 The New England Journal of Medicine
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