Survival without common toxicity criteria grade 3/4 toxicity for pemetrexed compared with docetaxel in previously treated patients with advanced non-small cell lung cancer (NSCLC): a risk-benefit analysis
| Autor: | Patrick Peterson, Patti Moore, Jean-Louis Pujol, Sofia Paul, Nadia Chouaki, Marc Salzberg, Donald A. Berry |
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| Rok vydání: | 2007 |
| Předmět: |
Oncology
Pulmonary and Respiratory Medicine Adult Male medicine.medical_specialty Guanine Lung Neoplasms non-small cell lung cancer (NSCLC) Antineoplastic Agents Docetaxel Pemetrexed Neutropenia Glutamates Internal medicine Carcinoma Non-Small-Cell Lung medicine Humans Prospective Studies Survival analysis Aged Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Hazard ratio Middle Aged medicine.disease Antineoplastic Agents Phytogenic Survival Analysis Treatment Outcome Toxicity Female Taxoids business Febrile neutropenia medicine.drug |
| Zdroj: | Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 2(5) |
| ISSN: | 1556-1380 |
| Popis: | In a recent large phase III study, previously treated patients with advanced non-small cell lung cancer who received pemetrexed demonstrated a survival time similar to patients who received docetaxel (median, 8.3 months with pemetrexed versus 7.9 months with docetaxel), with a more favorable toxicity profile, and significantly fewer Common Toxicity Criteria grade 3/4 toxicities. This is a retrospective risk-benefit analysis of survival without grade 3/4 toxicity, defined as the time to the first occurrence of Common Toxicity Criteria grade 3 or 4 toxicity or death, in the prospective phase III study comparing pemetrexed with docetaxel.A total of 541 patients (of 571 randomized) received either pemetrexed (500 mg/m intravenously [IV]) supplemented with vitamin B12 injections and oral folic acid or docetaxel (75 mg/m IV) on day 1 of 21-day cycles. Survival without grade 3/4 toxicity was analyzed using Kaplan-Meier and Cox methods.Pemetrexed demonstrated a statistically significantly longer survival without grade 3/4 toxicity compared with docetaxel (hazard ratio = 0.60, 95% confidence interval: 0.50-0.72; p0.0001). A supportive analysis based on selected grade 3/4 toxicities (neutropenia lasting5 days, febrile neutropenia, infection with neutropenia, anemia, thrombocytopenia, fatigue, nausea, vomiting, diarrhea, stomatitis, and neurosensory events) also demonstrated an advantage for pemetrexed (hazard ratio = 0.53; 95% confidence interval: 0.44-0.64; p0.0001).This analysis of survival without grade 3/4 toxicity suggests a benefit-to-risk profile that favors pemetrexed over docetaxel in the second-line treatment of patients with non-small cell lung cancer. |
| Databáze: | OpenAIRE |
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