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Background: The aim of this study was to evaluate whether docetaxel (taxotere) treatment with or without irinotecan improved patient outcomes with similar toxicity in recurrent non-small-cell lung cancer (NSCLC).
Patients And Methods: Patients with recurrent platinum-refractory NSCLC with Eastern Cooperative Oncology Group performance status of 0-2 were randomized to either docetaxel 30 mg/m(2) and irinotecan 60 mg/m(2) (days 1 and 8) or docetaxel 75 mg/m(2) (day 1), both administered every 3 weeks.
Results: A total of 130 patients were randomized. The response rate (RR) (20% versus 14%), overall survival (6.5 months versus 6.4 months) and 1-year survival (37% versus 34%) were similar in the combination and docetaxel arms, respectively. The combination arm demonstrated a longer time to tumor progression (TTP) (5.6 versus 4.8 months; P=0.065). Grade 3-4 neutropenia and anemia were similar in the combination and docetaxel arms. Grades 3-4 non-hematological toxicity (except diarrhea) was mild and was similar in the two groups. Grade 3-4 thrombocytopenia (17% versus 6%; P=0.04) and diarrhea (12% versus 3%; P=0.05) occurred more frequently in the combination arm.
Conclusions: The administration of irinotecan with docetaxel in platinum-refractory NSCLC prolonged TTP, but did not improve significantly RR, median survival or 1-year survival. Second-line docetaxel monotherapy offers significant and reproducible efficacy in platinum-refractory NSCLC.
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| http://dx.doi.org/10.1093/annonc/mdi053 | DOI Listing |
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Article Synopsis
- In the REVEL study, patients with advanced non-small-cell lung cancer (aNSCLC) who received ramucirumab combined with docetaxel experienced benefits over those who received a placebo with docetaxel, specifically in terms of treatment effectiveness.
- A post hoc analysis evaluated healthcare resource utilization (HCRU), measuring aspects such as hospitalizations, transfusions, and medications among patients, with statistical tests used to compare results between the two treatment groups.
- The findings indicated that there was no significant increase in HCRU associated with ramucirumab treatment compared to the control, suggesting that it is a viable option for patients with aggressive disease without putting additional strain on healthcare resources.
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