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Lung cancer patients in Japan, United States react differently to the same chemotherapy regimen

(NEW ORLEANS) -- A chemotherapy regimen commonly used to treat non-small cell lung cancer is both more effective and more toxic in Japanese patients than in American patients, researchers reported Saturday at the annual meeting of the American Society of Clinical Oncologists. The first of its kind, this analysis underscores the importance of genetic variations in medicine and points to a need for increased international collaboration in trials of new cancer treatments.

"Results of a cancer clinical trial performed in one part of the world may not necessarily hold true for populations in other regions," said lead investigator David Gandara, director of clinical research at UC Davis Cancer Center and professor of medicine at the UC Davis School of Medicine. "We need to be cautious when we extrapolate from one population to another."

The analysis compared results from two phase III clinical trials designed to evaluate the relative effectiveness of various treatments for patients with advanced non-small cell lung cancer. One trial was conducted in the United States, the other in Japan. The two trials were carefully structured from the outset, through a lengthy series of meetings between U.S. and Japanese investigators and representatives of the Japanese Ministry of Health, to have a "common arm." The approach allowed researchers to make direct comparisons of one chemotherapy regimen -- paclitaxel and carboplatin -- in both populations. Patients in both trials were closely matched in terms of age, gender, disease stage and tumor type.

The collaboration is the first to prospectively design a "common arm" in a U.S. cooperative group trial and in one conducted in another country. Median survival time was 12 months for the Japanese patients in the paclitaxel-carboplatin arm of the study, versus nine months for U.S. patients receiving the same regimen. Half of the Japanese patients (51 percent) survived one year, versus only slightly more than a th
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Contact: Claudia Morian
530-219-5053
University of California, Davis - Health System
5-Jun-2004


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