Objective: The goal of this study was to determine the effectiveness of taxane-containing regimens versus non-taxane-containing regimens using a metanalysis and its subsequent pharmacoeconomic assessment to define the role of taxanes as first-line therapy for non micro-cytic lung cancer.

Method: A search of the MEDLINE database from 2000 to June 2005 was performed. The search was restricted to phase-III clinical trials, and 29 papers were selected. Effectivity measures considered included: objective response, 1- and 2-year survival. Maentel-Haenszel combined odds ratio (OR) was estimated in the metanalysis. The statistical analysis of effectiveness across categories was performed using a one-way analysis of variance (ANOVA). Differences were statistically considered for p values = 0.01. All results obtained were weighted according to number of patients.

Results: OR estimates for the various effectiveness variables showed statistically significant differences when 2-year survival was considered both for taxanes in general and docetaxel specifically versus non-taxane regimens. These same results are seen when the effectiveness analysis is performed using ANOVA. For the pharmacoeconomic analysis taxane-free regimens were considered as reference, this being of choice for comparisons versus paclitaxel-containing regimens whereas the selection of docetaxel-containing schemes represents additional costs per extra effectiveness unit that oscillate between 26,559 and 96,527 (2-year survival and objective response, respectively) versus taxane-free regimens. The sensitivity analysis ultimately confirmed our study s results.

Conclusions: To conclude, taxane-containing schemes are valid therapeutic options, but at a very high cost.

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http://dx.doi.org/10.1016/s1130-6343(06)73978-2DOI Listing

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