Third generation chemotherapy regimens (3GR) improve survival over second generation regimens (2GR) in stage IIIB/IV non-small cell lung cancer (NSCLC): a meta-analysis of the published literature

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Meetings

Abstracts

2002 ASCO Annual Meeting

Third generation chemotherapy regimens (3GR) improve survival over second generation regimens (2GR) in stage IIIB/IV non-small cell lung cancer (NSCLC): a meta-analysis of the published literature

Sub-category:

Non-Small-Cell Lung Cancer

Category:

Lung Cancer

Meeting:

2002 ASCO Annual Meeting

Session Type and Session Title:

General Poster Session, Lung Cancer
Awards, Merit Award

Abstract No:

1222

Citation:

Proc Am Soc Clin Oncol 21: 2002 (abstr 1222)

Author(s):

Maria Q Baggstrom, Mark A Socinski, Thomas A Hensing, Charles Poole, Multidisciplinary Thoracic Oncology Program, Lineberger Comprehensive Cancer Center, Univ of North Carolina at Chapel Hill, Chapel Hill, NC; School of Public Health, Department of Epidemiology, Univ of North Carolina at Chapel Hill, Chapel Hill, NC.

Abstract:

Platinum-based therapy improves survival in stage IIIB/IV NSCLC. In the last decade, several new agents (paclitaxel, docetaxel, gemcitabine, vinorelbine, and irinotecan) have been developed with activity in NSCLC. In individual trials, benefit for 3GR has not been consistent. We sought to define the benefit these new agents have in combination with a platinum (3GR) as compared to 2GR (cisplatin alone or combined with vindesine, etoposide, etc) in untreated patients (pts) with stage IIIB/IV NSCLC by performing a meta-analysis of trials testing this paradigm. A literature search was done identifying peer-reviewed trials randomizing pts to either a 2GR or 3GR which were then evaluated for inclusion in the analysis. Two meta-analytic procedures were done using STATA on data from 8 trials (n= 3296 pts). Analysis of heterogeneity showed the trials to be very consistent; Begg's and Egger's tests showed little evidence of publication bias, thus allowing a summary analysis. 1-yr survival was increased for pts receiving a 3GR (summary Risk Ratio (RR) 1.14, 95% Confidence Limit (CL): 1.01, 1.29), with an absolute average increase in survival of 4% (Risk Difference (RD) 0.04, 95% CL: 0.00, 0.08) compared to 2GR. Response rate was also increased for pts receiving 3GR (RR 1.80, 95% CL: 1.51, 2.15), with an absolute average increase of 13% (RD 0.13, 95% CL: 0.09, 0.17) compared with 2GR. These estimates correspond to numbers needed to treat (NNT) to expect one additional favorable outcome (3GR vs 2GR) of ~ 8 pts for response and 24 pts for 1-yr survival. There was no evident difference in toxic deaths (3GR vs 2GR). Conclusions: Both response and 1-yr survival are improved with 3GR in stage IIIB/IV NSCLC. Although modest, the improvement is significant without an increase in treatment-related mortality.

3GR vs 2GR

Outcome	Measure	Estimate (95%CL) p-value	Heterogeneity (p-value)	Publication Bias (Begg, Egger) P-value
Resp Rate	RR	1.80 (1.51,2.15) <0.001	0.6	0.1, 0.04
	RD	0.13 (0.09,0.17) <0.001	0.8	0.9, 0.8

1yr Surv	RR	1.14 (1.01,1.29) 0.04	0.4	0.6, 0.3
	RD	0.04 (0.00,0.08) 0.04	0.4	0.6, 0.4

Associated Presentation(s):

1. Third generation chemotherapy regimens (3GR) improve survival over second generation regimens (2GR) in stage IIIB/IV non-small cell lung cancer (NSCLC): a meta-analysis of the published literature

Meeting: 2002 ASCO Annual Meeting
Presenter: Maria Q. Baggstrom, MD
Session: Lung Cancer (General Poster Session)

2. Third generation chemotherapy regimens (3GR) improve survival over second generation regimens (2GR) in stage IIIB/IV non-small cell lung cancer (NSCLC): a meta-analysis of the published literature

Meeting: 2002 ASCO Annual Meeting
Award Recipient: Maria Q. Baggstrom, MD
Session: Merit Award (Awards)

Other Abstracts in this Sub-Category:

		1. Single-agent (SA) versus combination chemotherapy (CC) in advanced non-small cell lung cancer (NSCLC): a CALGB randomized trial of efficacy, quality of life (QOL), and cost-effectiveness Meeting: 2002 ASCO Annual Meeting Abstract No: 2 First Author: Rogerio C Lilenbaum Category: Lung Cancer - Non-Small-Cell Lung Cancer
		2. Phase III single-blinded study of pemetrexed + cisplatin vs. cisplatin alone in chemonaive patients with malignant pleural mesothelioma Meeting: 2002 ASCO Annual Meeting Abstract No: 5 First Author: N J Vogelzang Category: Lung Cancer - Non-Small-Cell Lung Cancer
		3. A phase II study of the farnesyltransferase inhibitor R115777 in patients with advanced non-small cell lung cancer Meeting: 2002 ASCO Annual Meeting Abstract No: 1156 First Author: Alex A Adjei Category: Lung Cancer - Non-Small-Cell Lung Cancer
		More...

Abstracts by Maria Q Baggstrom:

1. Third generation chemotherapy regimens (3GR) improve survival over second generation regimens (2GR) in stage IIIB/IV non-small cell lung cancer (NSCLC): a meta-analysis of the published literature

Meeting: 2002 ASCO Annual Meeting Abstract No: 1222 First Author: Maria Q Baggstrom
Category: Lung Cancer - Non-Small-Cell Lung Cancer

More...

Presentations by Maria Q Baggstrom:

		1. Barriers for accrual to clinical trials in adult patients (pts) with thoracic malignancies. Meeting: 2006 ASCO Annual Meeting Presenter: Maria Q Baggstrom, MD Session: Health Services Research (General Poster Session)
		2. Addressing the optimal number of cytotoxic agents in stage IIIB/IV non-small cell lung cancer (NSCLC): A meta-analysis of the published literature Meeting: 2003 ASCO Annual Meeting Presenter: Maria Quintos Baggstrom, MD Session: Lung Cancer (Poster Discussion)
		3. Treatment of Breast, Prostate, and Colorectal Cancers: Historical Perspectives, Current State of the Art, and New Targets Meeting: 2003 ASCO Annual Meeting Speaker: Maria Quintos Baggstrom, MD Session: Treatment of Breast, Prostate, and Colorectal Cancers: Historical Perspectives, Current State of the Art, and New Targets (Education Symposium)
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Educational Book Manuscripts by Maria Q Baggstrom:

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