Recent improvement in the survival of patients with advanced nonsmall cell lung cancer enrolled in phase III trials of first-line, systemic chemotherapy

Katsuyuki Hotta, Yoshiro Fujiwara, Keitaro Matsuo, Takeshi Suzuki, Katsuyuki Kiura, Masahiro Tabata, Nagio Takigawa, Hiroshi Ueoka, Mitsune Tanimoto

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

BACKGROUND. Few studies have assessed formally whether treatment outcomes have improved substantially over the years for patients with advanced nonsmall cell lung cancer (NSCLC) enrolled in Phase III trials. The objective of the current investigation was to determine the time trends in outcomes for the patients in those trials. METHODS. The literature was searched to identify trials that addressed the role of chemotherapy regimens in the first-line setting for the treatment of advanced NSCLC. Trends were tested by using multiple regression analysis. RESULTS. In total, 121 Phase III trials were identified that involved 42,768 patients with 263 chemotherapy arms and 11 best supportive care (BSC) arms, all of which were initiated between 1982 and 2002. Although the number of randomized patients and the proportion of patients with metastatic disease had increased over the years, the number of patients with a poor performance status who were accrued into the trials had decreased. Cisplatin-based chemotherapy was been investigated most frequently during the period. The multiple regression analysis revealed a significant improvement in median survival and in the median time to disease progression over the years, with annual prolongations of 0.1203 months (3.609 days) and 0.0617 months (1.851 days), respectively (P <.0001 and P <.0130, respectively). In addition, the use of cisplatin and carboplatin was associated significantly with survival prolongation. The median survival for patients who received BSC also increased progressively over the years (P = .0487). CONCLUSIONS. The survival of patients with NSCLC in Phase III trials improved slowly but steadily over time, although the main factors responsible for this improvement remain unknown. Nonetheless, the current results also suggested that novel targets and new agents will be required in the future fight against advanced NSCLC.

Original languageEnglish
Pages (from-to)939-948
Number of pages10
JournalCancer
Volume109
Issue number5
DOIs
Publication statusPublished - Mar 1 2007

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Non-Small Cell Lung Carcinoma
Drug Therapy
Survival
Cisplatin
Regression Analysis
Carboplatin
Disease Progression

Keywords

  • Carboplatin
  • Cisplatin
  • Nonsmall-cell lung cancer
  • Survival improvement

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Recent improvement in the survival of patients with advanced nonsmall cell lung cancer enrolled in phase III trials of first-line, systemic chemotherapy. / Hotta, Katsuyuki; Fujiwara, Yoshiro; Matsuo, Keitaro; Suzuki, Takeshi; Kiura, Katsuyuki; Tabata, Masahiro; Takigawa, Nagio; Ueoka, Hiroshi; Tanimoto, Mitsune.

In: Cancer, Vol. 109, No. 5, 01.03.2007, p. 939-948.

Research output: Contribution to journalArticle

Hotta, Katsuyuki ; Fujiwara, Yoshiro ; Matsuo, Keitaro ; Suzuki, Takeshi ; Kiura, Katsuyuki ; Tabata, Masahiro ; Takigawa, Nagio ; Ueoka, Hiroshi ; Tanimoto, Mitsune. / Recent improvement in the survival of patients with advanced nonsmall cell lung cancer enrolled in phase III trials of first-line, systemic chemotherapy. In: Cancer. 2007 ; Vol. 109, No. 5. pp. 939-948.
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AU - Matsuo, Keitaro

AU - Suzuki, Takeshi

AU - Kiura, Katsuyuki

AU - Tabata, Masahiro

AU - Takigawa, Nagio

AU - Ueoka, Hiroshi

AU - Tanimoto, Mitsune

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N2 - BACKGROUND. Few studies have assessed formally whether treatment outcomes have improved substantially over the years for patients with advanced nonsmall cell lung cancer (NSCLC) enrolled in Phase III trials. The objective of the current investigation was to determine the time trends in outcomes for the patients in those trials. METHODS. The literature was searched to identify trials that addressed the role of chemotherapy regimens in the first-line setting for the treatment of advanced NSCLC. Trends were tested by using multiple regression analysis. RESULTS. In total, 121 Phase III trials were identified that involved 42,768 patients with 263 chemotherapy arms and 11 best supportive care (BSC) arms, all of which were initiated between 1982 and 2002. Although the number of randomized patients and the proportion of patients with metastatic disease had increased over the years, the number of patients with a poor performance status who were accrued into the trials had decreased. Cisplatin-based chemotherapy was been investigated most frequently during the period. The multiple regression analysis revealed a significant improvement in median survival and in the median time to disease progression over the years, with annual prolongations of 0.1203 months (3.609 days) and 0.0617 months (1.851 days), respectively (P <.0001 and P <.0130, respectively). In addition, the use of cisplatin and carboplatin was associated significantly with survival prolongation. The median survival for patients who received BSC also increased progressively over the years (P = .0487). CONCLUSIONS. The survival of patients with NSCLC in Phase III trials improved slowly but steadily over time, although the main factors responsible for this improvement remain unknown. Nonetheless, the current results also suggested that novel targets and new agents will be required in the future fight against advanced NSCLC.

AB - BACKGROUND. Few studies have assessed formally whether treatment outcomes have improved substantially over the years for patients with advanced nonsmall cell lung cancer (NSCLC) enrolled in Phase III trials. The objective of the current investigation was to determine the time trends in outcomes for the patients in those trials. METHODS. The literature was searched to identify trials that addressed the role of chemotherapy regimens in the first-line setting for the treatment of advanced NSCLC. Trends were tested by using multiple regression analysis. RESULTS. In total, 121 Phase III trials were identified that involved 42,768 patients with 263 chemotherapy arms and 11 best supportive care (BSC) arms, all of which were initiated between 1982 and 2002. Although the number of randomized patients and the proportion of patients with metastatic disease had increased over the years, the number of patients with a poor performance status who were accrued into the trials had decreased. Cisplatin-based chemotherapy was been investigated most frequently during the period. The multiple regression analysis revealed a significant improvement in median survival and in the median time to disease progression over the years, with annual prolongations of 0.1203 months (3.609 days) and 0.0617 months (1.851 days), respectively (P <.0001 and P <.0130, respectively). In addition, the use of cisplatin and carboplatin was associated significantly with survival prolongation. The median survival for patients who received BSC also increased progressively over the years (P = .0487). CONCLUSIONS. The survival of patients with NSCLC in Phase III trials improved slowly but steadily over time, although the main factors responsible for this improvement remain unknown. Nonetheless, the current results also suggested that novel targets and new agents will be required in the future fight against advanced NSCLC.

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