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.