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Triplets versus doublets, with or without cisplatin, in the first-line treatment of stage IIIB-IV non-small cell lung cancer (NSCLC) patients: a multicenter randomised factorial trial (FAST).

Authors :
Boni, C
Tiseo, M
Boni, L
Baldini, E
Recchia, F
Barone, C
Grossi, F
Germano, D
Matano, E
Marini, G
Labianca, R
Di Costanzo, F
Bagnulo, A
Pennucci, C
Caroti, C
Mencoboni, M
Zanelli, F
Prochilo, T
Cafferata, M A
Ardizzoni, A
Source :
British Journal of Cancer; 2/14/2012, Vol. 106 Issue 4, p658-665, 8p, 1 Diagram, 3 Charts, 1 Graph
Publication Year :
2012

Abstract

Background:The FAST is a 2 × 2 factorial trial addressing two questions: (1) the role of replacing cisplatin (P) with a non-platinum agent, vinorelbine (N), and (2) the role of adding a third agent, ifosfamide (I), in a doublet based on gemcitabine (G).Methods:A total of 433 stage IIIB-IV non-small cell lung cancer (NSCLC) patients were randomised to one of four arms: gemcitabine-cisplatin (GP), gemcitabine-vinorelbine, gemcitabine-ifosfamide-cisplatin or gemcitabine-ifosfamide-vinorelbine. Two comparisons were performed: N- vs P-containing regimens and I-triplets vs non-I doublets.Results:For N- vs P-containing regimens, adjusted overall survival was 9.7 vs 11.3 months (P=0.044), progression-free survival was 4.9 vs 6.4 months (P=0.020) and response rate was 24% vs 31% (P=0.124), respectively. No statistically significant difference was observed between doublets and triplets. Grade 3-4 haematological toxicity was significantly more frequent in P-containing therapy; grade 3-4 leucopenia was significantly more common in triplets. Concerning non-haematological toxicity, grade 3-4 nausea-vomiting was significantly increased in P-containing regimens.Conclusions:This trial provides evidence of a slight survival superiority of GP-containing regimens over platinum-free N-containing chemotherapy. This trial also confirms that the addition of a third chemotherapy agent (I) to a standard G-based doublet does not improve treatment outcome. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00070920
Volume :
106
Issue :
4
Database :
Complementary Index
Journal :
British Journal of Cancer
Publication Type :
Academic Journal
Accession number :
71719402
Full Text :
https://doi.org/10.1038/bjc.2011.606