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PurposeAlthough several randomized trials have been performed comparing weekly docetaxel (wD) with standard docetaxel once every 3 weeks (3wD) as second-line treatment of advanced non-small-cell lung cancer (NSCLC), no single trial had sufficient power to detect clinically relevant differences in survival.MethodsWe performed a meta-analysis based on individual patient data from all identified randomized trials comparing wD with 3wD as second-line treatment of advanced NSCLC. Baseline characteristics, treatment assigned, and outcome data were collected for each patient. The primary end point was overall survival. All statistical analyses were stratified by trial.ResultsFive eligible trials were identified for a total of 865 patients: 433 patients had been assigned to 3wD, and 432 patients had been assigned to wD. Median age was 62 years (range, 26 to 80 years). Performance status was 0 in 23%, 1 in 58%, and 2 in 16% of patients; 91% of the patients had received previous platinum, and 14% had received previous paclitaxel. With 733 deaths recorded (85%), median survival was 27.4 weeks for patients treated with 3wD, and 26.1 weeks for patients treated with wD (P = .24, log-rank test). There was no significant heterogeneity among the five trials. No relevant differential effect was detected in subgroup analyses. Significantly less severe and febrile neutropenia was reported with wD (P < .00001 for both), whereas no significant differences were observed for anemia, thrombocytopenia, and nonhematologic toxicity.ConclusionwD shows similar efficacy compared with 3wD, and represents an alternative for second-line treatment of advanced NSCLC.

Original publication

DOI

10.1200/jco.2006.09.8251

Type

Journal article

Journal

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

Publication Date

04/2007

Volume

25

Pages

1377 - 1382

Addresses

Clinical Trials Unit, National Cancer Institute, Naples, Italy.

Keywords

Humans, Carcinoma, Non-Small-Cell Lung, Lung Neoplasms, Cisplatin, Taxoids, Antineoplastic Agents, Antineoplastic Agents, Phytogenic, Chi-Square Distribution, Survival Analysis, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Male, Randomized Controlled Trials as Topic, Docetaxel