The impact of induction chemotherapy on the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer

G. J. Weiss, R. Rosell, F. Fossella, M. Perry, R. Stahel, F. Barata, B. Nguyen, S. Paul, P. McAndrews, N. Hanna, K. Kelly, Paul A. Bunn

Research output: Contribution to journalArticle

70 Scopus citations

Abstract

Background: Using data from a large phase III study of previously treated advanced non-small-cell lung cancer (NSCLC) that showed similar efficacy for pemetrexed and docetaxel, this retrospective analysis evaluates the impact of first-line chemotherapy on the outcome of second-line chemotherapy. Patients and methods: In all, 571 patients with advanced NSCLC were randomly assigned to receive pemetrexed 500 mg/m2 or docetaxel 75 mg/m2 on day 1 of a 21-day cycle. Comparisons were made based on type of first-line therapy [gemcitabine + platinum (GP), taxane + platinum (TP), or other therapies (OT)], response to initial therapy, time since initial therapy, and clinical characteristics. The two second-line treatment groups were pooled for this analysis due to similar efficacy and were assumed to have no interaction with the first-line therapies. Results: Baseline characteristics were generally balanced. By multivariate analysis, gender, stage at diagnosis, performance status (PS), and best response to first-line therapy significantly influenced overall survival (OS). Additional factors by univariate analysis, histology, and time elapsed from first- to second-line therapy significantly influenced OS. Conclusions: Future trials in the second-line setting should stratify patients by gender, stage at diagnosis, PS, and best response to first-line therapy.

Original languageEnglish (US)
Pages (from-to)453-460
Number of pages8
JournalAnnals of Oncology
Volume18
Issue number3
DOIs
StatePublished - Mar 1 2007

Keywords

  • Chemotherapy
  • Docetaxel
  • Non-small-cell lung cancer
  • Pemetrexed
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Weiss, G. J., Rosell, R., Fossella, F., Perry, M., Stahel, R., Barata, F., Nguyen, B., Paul, S., McAndrews, P., Hanna, N., Kelly, K., & Bunn, P. A. (2007). The impact of induction chemotherapy on the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer. Annals of Oncology, 18(3), 453-460. https://doi.org/10.1093/annonc/mdl454