European trial finds old lung cancer treatment may still be best

The first clinical trial to compare directly two of the most widely-used drugs in advanced lung cancer, cisplatinin and carboplatin (both in combination with paclitaxel) have concluded that the older drug, cisplatin, is the better treatment.

Patients given cisplatin and paclitaxel had better survival rates and their quality of life was just as good as patients receiving carboplatin and paclitaxel.

The phase III multi-national European trial involving 618 patients with advanced non small-cell lung cancer (NSCLC) is reported in the new issue of Annals of Oncology.*

Cisplatin tends to be the preferred standard chemotherapy for lung cancer in Europe, but in the USA carboplatin is normally used. The new findings are in contrast to a recent similar study in the USA** where a four-arm trial comparing a range of treatments showed no advantage for any one chemotherapy combination over another.

In the European trial the response rates to the two treatments were similar - 28% in the cisplatin/paclitaxel arm and 25% in the carboplatin/paclitaxel arm, but the median survival in the cisplatin arm was significantly better at 9.8 months compared with 8.5 months. The one-year survival rate was 38% in the cisplatin/paclitaxel arm compared with 33% in the carboplatin/paclitaxel arm and the two-year survival rate was 15% and 9% respectively.

Lead investigator Dr Rafael Rosell from the Hospital Germans Trias i Pujol in Barcelona, Spain said: "This large European randomised study can contribute greatly to resolving the longstanding debate on the superiority of carboplatin or cisplatin-based chemotherapy in lung cancer. Although paclitaxel/carboplatin yielded a similar response rate, the significantly longer median survival obtained with paclitaxel/cisplatin indicates that cisplatin-based chemotherapy should be the first treatment option." However, Dr Rosell stressed that paclitaxel/carboplatin was still a viable alternative.

In an acco

Contact: Margaret Willson
European Society for Medical Oncology

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