Format

Send to

Choose Destination
See comment in PubMed Commons below
Lung Cancer. 2012 May;76(2):222-7. doi: 10.1016/j.lungcan.2011.10.021. Epub 2011 Nov 23.

Comparison of pemetrexed plus cisplatin with other first-line doublets in advanced non-small cell lung cancer (NSCLC): a combined analysis of three phase 3 trials.

Author information

1
Eli Lilly and Company or one of its subsidiaries, Indianapolis, IN, USA. treatjo@lilly.com

Abstract

INTRODUCTION:

In a first-line study of advanced NSCLC, pemetrexed-cisplatin was more effective among patients with adenocarcinoma and large-cell carcinoma compared with gemcitabine-cisplatin (median survival of 11.8 versus 10.4 months, P=.005), while survival with pemetrexed-cisplatin was shorter than with gemcitabine-cisplatin in patients with squamous cell carcinoma. The comparability of pemetrexed-cisplatin to other commonly used regimens within histology subgroups needs to be explored.

METHODS:

This retrospective analysis combined the patient-level data from three phase 3 randomized controlled trials that compared the efficacy of different third generation platinum- and non-platinum based doublets. Unadjusted median survival times and Cox covariate-adjusted treatment hazard ratio (HR) estimates were calculated. Overall results and subgroups by histological type were reported.

RESULTS:

This combined analysis consisted of 3467 patients. In the overall analysis, adjusted HRs favored pemetrexed (HR <1.0) to each of the other 5 regimens, though none of these HRs were statistically significant. Among patients with non-squamous histology, pemetrexed-cisplatin produced favorable HRs to each of the other regimens, achieving statistical significance when compared with vinorelbine-cisplatin (HR=0.67; 95% confidence intervals [CI]: 0.50, 0.91) and gemcitabine-cisplatin (HR=0.85; 95% CI: 0.75, 0.97). Among patients with squamous histology, 4 of the 5 comparison regimens produced favorable HRs (HR >1.0) when compared with pemetrexed-cisplatin, with only the comparison with gemcitabine-cisplatin achieving statistical significance (HR=1.23; 95% CI: 1.00, 1.51).

CONCLUSION:

In the absence of randomized clinical trial data comparing pemetrexed-cisplatin to commonly used doublets in advanced NSCLC other than gemcitabine-cisplatin, this combined analysis of multiple trials provides estimates for such comparisons.

PMID:
22115704
DOI:
10.1016/j.lungcan.2011.10.021
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center