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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.

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    Authors
    Le Chevalier, Thierry
    Scagliotti, Giorgio V
    Natale, Ronald B
    Danson, Sarah
    Rosell, Rafael
    Stahel, R
    Thomas, P
    Rudd, R M
    Vansteenkiste, Johan
    Thatcher, Nick
    Manegold, Christian
    Pujol, J L
    Van Zandwijk, N
    Gridelli, Cesare
    Van Meerbeeck, Jan
    Crino, L
    Brown, A
    Fitzgerald, P
    Aristides, M
    Schiller, Joan H
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    Affiliation
    Institute Gustave-Roussy, 39-53 Rue Camille Desmoulins, F-94800 Villejuif, France. tle-che@igr.fr
    Issue Date
    2005-01
    
    Metadata
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    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% 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).
    Citation
    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. 2005, 47 (1):69-80 Lung Cancer
    Journal
    Lung Cancer
    URI
    http://hdl.handle.net/10541/75838
    DOI
    10.1016/j.lungcan.2004.10.014
    PubMed ID
    15603856
    Type
    Article
    Language
    en
    ISSN
    0169-5002
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.lungcan.2004.10.014
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