Cited by 4,955Lung Cancer Diagnosis and TreatmentLung Cancer Treatments and MutationsLung Cancer Research Studies

Comparison of Four Chemotherapy Regimens for Advanced Non–Small-Cell Lung Cancer

Abstract

BACKGROUND: We conducted a randomized study to determine whether any of three chemotherapy regimens was superior to cisplatin and paclitaxel in patients with advanced non-small-cell lung cancer. METHODS: A total of 1207 patients with advanced non-small-cell lung cancer were randomly assigned to a reference regimen of cisplatin and paclitaxel or to one of three experimental regimens: cisplatin and gemcitabine, cisplatin and docetaxel, or carboplatin and paclitaxel. RESULTS: The response rate for all 1155 eligible patients was 19 percent, with a median survival of 7.9 months (95 percent confidence interval, 7.3 to 8.5), a 1-year survival rate of 33 percent (95 percent confidence interval, 30 to 36 percent), and a 2-year survival rate of 11 percent (95 percent confidence interval, 8 to 12 percent). The response rate and survival did not differ significantly between patients assigned to receive cisplatin and paclitaxel and those assigned to receive any of the three experimental regimens. Treatment with cisplatin and gemcitabine was associated with a significantly longer time to the progression of disease than was treatment with cisplatin and paclitaxel but was more likely to cause grade 3, 4, or 5 renal toxicity (in 9 percent of patients, vs. 3 percent of those treated with cisplatin plus paclitaxel). Patients with a performance status of 2 had a significantly lower rate of survival than did those with a performance status of 0 or 1. CONCLUSIONS: None of four chemotherapy regimens offered a significant advantage over the others in the treatment of advanced non-small-cell lung cancer.

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Crossref · 10.1056/nejmoa011954

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Authors
Schiller, J. H., Harrington, D., Belani, C. P., Langer, C., Sandler, A., Krook, J., Zhu, J., & Johnson, D. H.
Affiliations
  • University of Wisconsin–Madison (US)
  • Dana-Farber Cancer Institute (US)
  • UPMC Hillman Cancer Center (US)
  • Fox Chase Cancer Center (US)
  • Indiana University Indianapolis (US)
  • Duluth Clinic (US)
  • Vanderbilt University (US)
Venue
New England Journal of Medicine
Published
2002-01-10
Volume
346
Issue
2
Pages
92-98
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2037139573
Cited by
4,955
References
0
Citations by year
2026: 81 · 2025: 66 · 2024: 85 · 2023: 134 · 2022: 145 · 2021: 145 · 2020: 171 · 2019: 190 · 2018: 208 · 2017: 229 · 2016: 238 · 2015: 267 · 2014: 282 · 2013: 287 · 2012: 276
FWCI
171.09
Type
journal article
Language
en
Open access
closed
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Cancer Institute (CA-23318, U10CA023318)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
Keywords
advanced non-small cell lung cancer, chemotherapy regimens, cisplatin, paclitaxel, gemcitabine, docetaxel, carboplatin, nephrotoxicity, time to progression, survival, performance status
MeSH terms
Docetaxel, Gemcitabine, Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Non-Small-Cell Lung, Cisplatin, Deoxycytidine, Female, Humans, Lung Neoplasms, Male, Middle Aged, Survival Analysis, Paclitaxel, Disease-Free Survival, Taxoids

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