In a nutshell
The authors compared the overall survival benefits of two chemotherapy-based combination treatments in advanced non-small cell lung cancer (NSCLC). The combination treatments were S1 plus cisplatin (Platinol) and docetaxel (Taxotere) plus cisplatin.
Some background
NSCLC is the most common type of lung cancer. In the advanced stage of NSCLC (stage III/IV), the cancer spreads from the lungs to other parts of the body. Platinum-based combination chemotherapy (e.g. cisplatin, carboplatin (Paraplatin)) has been the standard treatment for advanced NSCLC. Cisplatin in combination with another type of chemotherapy drug named docetaxel has been shown to improve overall survival and general well-being.
S1 (TS-1) is an oral anti-cancer drug effective in the treatment of NSCLC. It contains three different medicinal components in a single capsule. In an early stage clinical trial of S1 with cisplatin, the combination was well tolerated and improved overall survival in advanced NSCLC compared to a commonly-used two-drug chemotherapy combination. It needs to be demonstrated whether this combination therapy is as effective in a larger clinical trial.
Methods & findings
The authors aimed to compare the overall effectiveness of two chemotherapy-based combination treatments containing cisplatin: S1 plus cisplatin and docetaxel plus cisplatin.
Overall, 608 patients with advanced NSCLC were randomly assigned to receive either oral S1 plus cisplatin or docetaxel plus cisplatin for 6 cycles of treatment. The overall survival for S1-cisplatin group was 16.1 months compared to 17.1 moths for docetaxel-cisplatin. Progression-free survival (time following treatment before the disease progresses) was similar in both the groups. The S1-cisplatin combination provided improved quality of life and was better tolerated among advanced NSCLC patients compared to docetaxel-cisplatin combination. Patients in S1-cisplatin group experienced significantly less infection (5.3%), low white-blood cell count (22.9%) and hair loss (12.3%) compared to patients in docetaxel-cisplatin group (infection: 14.5%, low white-blood cell count: 73.4% and hair loss: 59.3%).
The bottom line
The authors concluded that S1-cisplatin combination chemotherapy was better tolerated compared to docetaxel-cisplatin combination in advanced NSCLC. The overall survival in both the treatment groups were similar.
The fine print
This study was undertaken in Japanese patients, and so may need further evaluation in other population groups.
Published By :
Annals of oncology
Date :
Apr 23, 2015
