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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.
- Source :
-
Lung cancer (Amsterdam, Netherlands) [Lung Cancer] 2005 Jan; Vol. 47 (1), pp. 69-80. - Publication Year :
- 2005
-
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.<br />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.<br />Results: A significant reduction in overall mortality in favor of gemcitabine-platinum regimens was observed, hazard ratio (HR) 0.90 (95% CI: 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 (CI: 0.71-0.9985). Analysis of third-generation agent plus platinum regimens showed a non-significant trend favoring gemcitabine-platinum regimens, HR 0.93 (CI: 0.86-1.01). There was a significant decrease in the risk of disease progression in favor of gemcitabine-platinum regimens, HR 0.88 (CI: 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 (CI: 0.77-0.94), and third-generation agent plus platinum regimens, HR 0.89 (CI: 0.82-0.96).
- Subjects :
- Carboplatin administration & dosage
Cisplatin administration & dosage
Deoxycytidine administration & dosage
Disease Progression
Disease-Free Survival
Humans
Randomized Controlled Trials as Topic
Risk Factors
Survival Analysis
Treatment Outcome
Gemcitabine
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carboplatin therapeutic use
Carcinoma, Non-Small-Cell Lung drug therapy
Carcinoma, Non-Small-Cell Lung pathology
Cisplatin therapeutic use
Deoxycytidine analogs & derivatives
Deoxycytidine therapeutic use
Lung Neoplasms drug therapy
Lung Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 0169-5002
- Volume :
- 47
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Lung cancer (Amsterdam, Netherlands)
- Publication Type :
- Academic Journal
- Accession number :
- 15603856
- Full Text :
- https://doi.org/10.1016/j.lungcan.2004.10.014