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Efficacy of gemcitabine plus platinum chemotherapy compared with other platinum containing regimens in advanced non-small-cell lung cancer: a meta-analysis of survival outcomes

Identifieur interne : 00A656 ( Main/Exploration ); précédent : 00A655; suivant : 00A657

Efficacy of gemcitabine plus platinum chemotherapy compared with other platinum containing regimens in advanced non-small-cell lung cancer: a meta-analysis of survival outcomes

Auteurs : T. Le Chevalier [France, Belgique, Royaume-Uni, Allemagne, Pays-Bas, Italie, Australie, États-Unis] ; G. Scagliotti [Italie] ; R. Natale [États-Unis] ; S. Danson [Royaume-Uni] ; R. Rosell [Espagne] ; R. Stahel [Suisse] ; P. Thomas [France] ; R. M. Rudd ; J. Vansteenkiste ; N. Thatcher ; C. Manegold ; J.-L. Pujol ; N. Van Zandwijk ; C. Gridelli ; J. P. Van Meerbeeck ; L. Crino ; A. Brown ; P. Fitzgerald ; M. Aristides ; J. H. Schiller

Source :

RBID : Pascal:05-0077031

Descripteurs français

English descriptors

Abstract

Purpose: Gemcitabine-platinum combination activity has been clearly established in a number of phase II studies. It has also been compared against other combinations in many phase III trials. It is generally believed that all such regimens have an equivalent impact on survival. This meta-analysis aims to quantify the treatment effect of gemcitabine plus a platinum agent in the treatment of advanced NSCLC and compare the combination to other regimens used globally. Design: Data from a total of 4556 patients from 13 randomized trials investigating gemcitabine in combination with a platinum agent versus any other platinum-containing regimen were included in a meta-analysis of time-to-event outcomes. Results: A significant reduction in overall mortality in favor of gemcitabine-platinum regimens was observed, hazard ratio (HR) 0.90 (95% Cl: 0.84-0.96) with an absolute benefit at 1 year of 3.9%. Median survival was 9.0 months for the gemcitabine-platinum regimens and 8.2 months for the comparator regimens. Sub-group analysis of the first- and second-generation platinum-based comparator regimens also indicated a significant benefit for gemcitabine-platinum regimens, HR 0.84 (Cl: 0.71-0.9985). Analysis of third-generation agent plus platinum regimens showed a non-significant trend favoring gemcitabine-platinum regimens, HR 0.93 (Cl: 0.86-1.01). There was a significant decrease in the risk of disease progression in favor of gemcitabine-platinum regimens, HR 0.88 (Cl: 0.82-0.93). An absolute benefit of 4.2% at 1 year was estimated. Median progression-free survival was 5.1 months for gemcitabine-platinum regimens compared with 4.4 months for the comparator regimens. Sub-group analysis indicated a statistically significant progression-free survival benefit for patients assigned to gemcitabine-platinum treatment compared to first- and second-generation platinum regimens, HR 0.85 (Cl: 0.77-0.94), and third-generation agent plus platinum regimens, HR 0.89 (Cl: 0.82-0.96).


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Le document en format XML

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<name sortKey="Manegold, C" sort="Manegold, C" uniqKey="Manegold C" first="C." last="Manegold">C. Manegold</name>
</author>
<author>
<name sortKey="Pujol, J L" sort="Pujol, J L" uniqKey="Pujol J" first="J.-L." last="Pujol">J.-L. Pujol</name>
</author>
<author>
<name sortKey="Van Zandwijk, N" sort="Van Zandwijk, N" uniqKey="Van Zandwijk N" first="N." last="Van Zandwijk">N. Van Zandwijk</name>
</author>
<author>
<name sortKey="Gridelli, C" sort="Gridelli, C" uniqKey="Gridelli C" first="C." last="Gridelli">C. Gridelli</name>
</author>
<author>
<name sortKey="Van Meerbeeck, J P" sort="Van Meerbeeck, J P" uniqKey="Van Meerbeeck J" first="J. P." last="Van Meerbeeck">J. P. Van Meerbeeck</name>
</author>
<author>
<name sortKey="Crino, L" sort="Crino, L" uniqKey="Crino L" first="L." last="Crino">L. Crino</name>
</author>
<author>
<name sortKey="Brown, A" sort="Brown, A" uniqKey="Brown A" first="A." last="Brown">A. Brown</name>
</author>
<author>
<name sortKey="Fitzgerald, P" sort="Fitzgerald, P" uniqKey="Fitzgerald P" first="P." last="Fitzgerald">P. Fitzgerald</name>
</author>
<author>
<name sortKey="Aristides, M" sort="Aristides, M" uniqKey="Aristides M" first="M." last="Aristides">M. Aristides</name>
</author>
<author>
<name sortKey="Schiller, J H" sort="Schiller, J H" uniqKey="Schiller J" first="J. H." last="Schiller">J. H. Schiller</name>
</author>
</analytic>
<series>
<title level="j" type="main">Lung cancer</title>
<title level="j" type="abbreviated">Lung cancer</title>
<idno type="ISSN">0169-5002</idno>
<imprint>
<date when="2005">2005</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">Lung cancer</title>
<title level="j" type="abbreviated">Lung cancer</title>
<idno type="ISSN">0169-5002</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Antineoplastic agent</term>
<term>Carboplatin</term>
<term>Chemotherapy</term>
<term>Cisplatin</term>
<term>Comparative study</term>
<term>Efficiency</term>
<term>Evolution</term>
<term>Gemcitabine</term>
<term>Lung cancer</term>
<term>Metaanalysis</term>
<term>Metastasis</term>
<term>Non small cell carcinoma</term>
<term>Platinum</term>
<term>Prognosis</term>
<term>Respiratory disease</term>
<term>Survival</term>
<term>Treatment</term>
<term>non-small cell lung carcinoma</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Carcinome non petite cellule bronchopulmonaire</term>
<term>Carcinome non petite cellule</term>
<term>Métastase</term>
<term>Appareil respiratoire pathologie</term>
<term>Gemcitabine</term>
<term>Cisplatine</term>
<term>Carboplatine</term>
<term>Chimiothérapie</term>
<term>Efficacité</term>
<term>Anticancéreux</term>
<term>Platine</term>
<term>Traitement</term>
<term>Etude comparative</term>
<term>Métaanalyse</term>
<term>Survie</term>
<term>Pronostic</term>
<term>Evolution</term>
<term>Cancer du poumon</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Platine</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Purpose: Gemcitabine-platinum combination activity has been clearly established in a number of phase II studies. It has also been compared against other combinations in many phase III trials. It is generally believed that all such regimens have an equivalent impact on survival. This meta-analysis aims to quantify the treatment effect of gemcitabine plus a platinum agent in the treatment of advanced NSCLC and compare the combination to other regimens used globally. Design: Data from a total of 4556 patients from 13 randomized trials investigating gemcitabine in combination with a platinum agent versus any other platinum-containing regimen were included in a meta-analysis of time-to-event outcomes. Results: A significant reduction in overall mortality in favor of gemcitabine-platinum regimens was observed, hazard ratio (HR) 0.90 (95% Cl: 0.84-0.96) with an absolute benefit at 1 year of 3.9%. Median survival was 9.0 months for the gemcitabine-platinum regimens and 8.2 months for the comparator regimens. Sub-group analysis of the first- and second-generation platinum-based comparator regimens also indicated a significant benefit for gemcitabine-platinum regimens, HR 0.84 (Cl: 0.71-0.9985). Analysis of third-generation agent plus platinum regimens showed a non-significant trend favoring gemcitabine-platinum regimens, HR 0.93 (Cl: 0.86-1.01). There was a significant decrease in the risk of disease progression in favor of gemcitabine-platinum regimens, HR 0.88 (Cl: 0.82-0.93). An absolute benefit of 4.2% at 1 year was estimated. Median progression-free survival was 5.1 months for gemcitabine-platinum regimens compared with 4.4 months for the comparator regimens. Sub-group analysis indicated a statistically significant progression-free survival benefit for patients assigned to gemcitabine-platinum treatment compared to first- and second-generation platinum regimens, HR 0.85 (Cl: 0.77-0.94), and third-generation agent plus platinum regimens, HR 0.89 (Cl: 0.82-0.96).</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Australie</li>
<li>Belgique</li>
<li>Espagne</li>
<li>France</li>
<li>Italie</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Bade-Wurtemberg</li>
<li>Catalogne</li>
<li>District de Karlsruhe</li>
<li>Grand Londres</li>
<li>Grand Manchester</li>
<li>Hollande-Septentrionale</li>
<li>Languedoc-Roussillon</li>
<li>Occitanie (région administrative)</li>
<li>Provence-Alpes-Côte d'Azur</li>
<li>Île-de-France</li>
</region>
<settlement>
<li>Amsterdam</li>
<li>Barcelone</li>
<li>Heidelberg</li>
<li>Londres</li>
<li>Manchester</li>
<li>Marseille</li>
<li>Montpellier</li>
<li>Villejuif</li>
</settlement>
</list>
<tree>
<noCountry>
<name sortKey="Aristides, M" sort="Aristides, M" uniqKey="Aristides M" first="M." last="Aristides">M. Aristides</name>
<name sortKey="Brown, A" sort="Brown, A" uniqKey="Brown A" first="A." last="Brown">A. Brown</name>
<name sortKey="Crino, L" sort="Crino, L" uniqKey="Crino L" first="L." last="Crino">L. Crino</name>
<name sortKey="Fitzgerald, P" sort="Fitzgerald, P" uniqKey="Fitzgerald P" first="P." last="Fitzgerald">P. Fitzgerald</name>
<name sortKey="Gridelli, C" sort="Gridelli, C" uniqKey="Gridelli C" first="C." last="Gridelli">C. Gridelli</name>
<name sortKey="Manegold, C" sort="Manegold, C" uniqKey="Manegold C" first="C." last="Manegold">C. Manegold</name>
<name sortKey="Pujol, J L" sort="Pujol, J L" uniqKey="Pujol J" first="J.-L." last="Pujol">J.-L. Pujol</name>
<name sortKey="Rudd, R M" sort="Rudd, R M" uniqKey="Rudd R" first="R. M." last="Rudd">R. M. Rudd</name>
<name sortKey="Schiller, J H" sort="Schiller, J H" uniqKey="Schiller J" first="J. H." last="Schiller">J. H. Schiller</name>
<name sortKey="Thatcher, N" sort="Thatcher, N" uniqKey="Thatcher N" first="N." last="Thatcher">N. Thatcher</name>
<name sortKey="Van Meerbeeck, J P" sort="Van Meerbeeck, J P" uniqKey="Van Meerbeeck J" first="J. P." last="Van Meerbeeck">J. P. Van Meerbeeck</name>
<name sortKey="Van Zandwijk, N" sort="Van Zandwijk, N" uniqKey="Van Zandwijk N" first="N." last="Van Zandwijk">N. Van Zandwijk</name>
<name sortKey="Vansteenkiste, J" sort="Vansteenkiste, J" uniqKey="Vansteenkiste J" first="J." last="Vansteenkiste">J. Vansteenkiste</name>
</noCountry>
<country name="France">
<region name="Île-de-France">
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
</region>
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
<name sortKey="Thomas, P" sort="Thomas, P" uniqKey="Thomas P" first="P." last="Thomas">P. Thomas</name>
</country>
<country name="Belgique">
<noRegion>
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
</noRegion>
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
</country>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
</region>
<name sortKey="Danson, S" sort="Danson, S" uniqKey="Danson S" first="S." last="Danson">S. Danson</name>
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
</country>
<country name="Allemagne">
<region name="Bade-Wurtemberg">
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
</region>
</country>
<country name="Pays-Bas">
<region name="Hollande-Septentrionale">
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
</region>
</country>
<country name="Italie">
<noRegion>
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
</noRegion>
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
<name sortKey="Scagliotti, G" sort="Scagliotti, G" uniqKey="Scagliotti G" first="G." last="Scagliotti">G. Scagliotti</name>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
</noRegion>
</country>
<country name="États-Unis">
<noRegion>
<name sortKey="Le Chevalier, T" sort="Le Chevalier, T" uniqKey="Le Chevalier T" first="T." last="Le Chevalier">T. Le Chevalier</name>
</noRegion>
<name sortKey="Natale, R" sort="Natale, R" uniqKey="Natale R" first="R." last="Natale">R. Natale</name>
</country>
<country name="Espagne">
<region name="Catalogne">
<name sortKey="Rosell, R" sort="Rosell, R" uniqKey="Rosell R" first="R." last="Rosell">R. Rosell</name>
</region>
</country>
<country name="Suisse">
<noRegion>
<name sortKey="Stahel, R" sort="Stahel, R" uniqKey="Stahel R" first="R." last="Stahel">R. Stahel</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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