TUESDAY, Aug. 9 (HealthDay News) -- Despite more toxic effects, doublet chemotherapy with carboplatin and weekly paclitaxel is associated with significantly higher survival benefits than monotheraphy with either vinorelbine or gemcitabine in elderly patients with advanced non-small-cell lung cancer (NSCLC), according to a study published online Aug. 9 in The Lancet.
Elisabeth Quoix, M.D., from the Université de Strasbourg in France, and colleagues compared a doublet chemotherapy regimen of carboplatin and paclitaxel with monotherapy in elderly patients with advanced NSCLC. Out of the 451 patients enrolled (median age 77 years) with a World Health Organization performance status score of zero to two, 226 were randomly assigned to five cycles (two weeks on and one week off) of vinorelbine or gemcitabine monotherapy, and 225 patients received either four cycles (three weeks on, one week off) of carboplatin on day one, and additional paclitaxel on days one, eight, and 15. Analysis was done by intention to treat. Overall survival was the primary end point. The participants were followed up for an average of 30.3 months.
The investigators found that the median overall survival rate was 10.3 and 6.2 months with doublet chemotherapy and monotherapy, respectively (hazard ratio, 0.64), and the one-year survival rates were 44.5 and 25.4 percent, respectively. Doublet chemotherapy was more frequently associated with toxic effects than monotherapy, of which decreased neutrophil count (108 versus 28) and asthenia (23 versus 13) were the most common effects.
"Despite increased toxic effects, platinum-based doublet chemotherapy was associated with survival benefits compared with vinorelbine or gemcitabine monotherapy in elderly patients with NSCLC," the authors write.
Several of the study authors disclosed financial relationships with Bristol-Myers Squibb, Lilly, and Roche.