Palliative chemotherapy for metastatic lung cancer is now standard. Platinum-based combinations were the first regimens to convincingly have an impact on survival and have been the standard of care in NSCLC. A European study showed that gemcitabine/cisplatin was essentiall equivalent to paclitaxel and a platin and the former became standard in Europe whereas the latter is most often used in the USA. More recently Avastin has been shown to add to the survival benefit. Taxotere has been established as roughly equivalent to Taxol and other drugs in phase III trial. TAXOTERE in combination with cisplatin is indicated for the treatment of patients with unresectable, locally advanced or metastatic non-small cell lung cancer who have not previously received chemotherapy for this condition.
In clinical trials including patients with unresectable, locally advanced or metastatic NSCLC, first-line therapy with Taxotere® + cisplatin has demonstrated the following benefits vs. vinorelbine + cisplatin:
longer median survival than the vinorelbine + cisplatin group (10.9 months vs. 10.0 months, respectively; P=.122(NS) and higher overall response rate than the vinorelbine + cisplatin group (31.6% vs. 24.4%, respectively; P=NS) TAX3201. More patients in the Taxotere® + cisplatin group completed all 6 cycles of therapy vs. patients in the vinorelbine + cisplatin (49.8% vs. 33.6%, respectively). NCCN includes docetaxel and cisplatin among other alternatives (p.35).
Fossella FV, DeVore R, Kerr RN, et al. Randomized phase III trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non–small-cell lung cancer previously treated with platinum-containing chemotherapy regimens. J Clin Oncol. 2000;18:2354-2362.
Fossella F, Pereira JR, von Pawel J, et al. Randomized, multinational, phase III study of docetaxel plus platinum combinations versus vinorelbine plus cisplatin for advanced non–small-cell lung cancer: the TAX 326 Study Group. J Clin Oncol. 2003;21:3016-3024.