Platinum rechallenge in patients with advanced NSCLC: a pooled analysis.

Platinum rechallenge in patients with advanced NSCLC: a pooled analysis.

Lung cancer (Amsterdam, Netherlands) (2013-07-31)

Fausto Petrelli, Andrea Coinu, Mary Cabiddu, Mara Ghilardi, Mara Ardine, Sandro Barni

ABSTRACT

The sole agents pemetrexed (PEM), docetaxel and anti-EGFR agents are approved second-line therapies for non-small cell lung cancer (NSCLC) after failure with cisplatin-based doublets. The potential usefulness of platinum-based doublets as rechallenge for second-line chemotherapy has not yet been established. Studies that enrolled NSCLC platinum pre-treated patients were identified using electronic databases (MEDLINE and EMBASE). Pemetrexed and taxanes (TAXs)-based platinum combinations were considered. A systematic review was conducted using Comprehensive Meta-Analysis (version 2.2.064) software to calculate the event rate of response and 95% confidence interval. Median weighted progression-free survival (PFS) and overall survival (OS) time for PEM and TAXs-based doublets were compared by two-sided Student's t test. We tested for significant heterogeneity by Cochran's chi-square test and I(2) index. Eleven studies published between 1999 and 2012 were included in this analysis with a total of 607 patients enrolled; 468 were treated with PEM-doublets and 139 with TAXs-doublets. The overall response rate was 27.5% with a higher response rate of 37.8% (range, 29.7-46.7%) for TAXs-based treatment vs. 22% (range, 13.4-34.1%) for PEM-based combinations; (p < 0.0001). Median PFS and OS were 3.9 and 8.7 months with weighted PFS of 3.9 vs. 5.3 months (p < 0.0001) and similar OS for PEM vs. TAXs-based doublets. With the limitations of small and not randomised trials included, this pooled analysis shows that NSCLC patients who relapsed after a first-line platinum-based chemotherapy obtain a tumour response of 27% from a platinum rechallenge containing PEM or TAXs. Response rate and median PFS appear better with TAXs-than with PEM-doublets.

MATERIALS

Product Number

Brand

Product Description

520799

Sigma-Aldrich

Platinum black, low bulk density, ≥99.9% trace metals basis

298093

Sigma-Aldrich

Platinum, gauze, 100 mesh, 99.9% trace metals basis

267244

Sigma-Aldrich

Platinum, foil, thickness 0.025 mm, 99.9% trace metals basis

205915

Sigma-Aldrich

Platinum black, black, powder, ≤20 μm, ≥99.95% trace metals basis

349402

Sigma-Aldrich

Platinum, wire, diam. 0.25 mm, 99.9% trace metals basis

349348

Sigma-Aldrich

Platinum, foil, thickness 0.127 mm, 99.99% trace metals basis

349380

Sigma-Aldrich

Platinum, foil, thickness 0.1 mm, 99.9% trace metals basis

357375

Sigma-Aldrich

Platinum, wire, diam. 0.076 mm, ≥99.99% trace metals basis

327484

Sigma-Aldrich

Platinum, shot, ≤3 mm, ≥99.9% trace metals basis

267821

Sigma-Aldrich

Platinum, wire, diam. 0.127 mm, 99.9% trace metals basis

520780

Sigma-Aldrich

Platinum black, fuel cell grade, ≥99.9% trace metals basis

349321

Sigma-Aldrich

Platinum, foil, thickness 0.25 mm, 99.99% trace metals basis

444685

Sigma-Aldrich

Platinum, wire, diam. 2.0 mm, 99.9% trace metals basis

GF15342016

Platinum, tube, 500mm, outside diameter 1.2mm, inside diameter 1.0mm, wall thickness 0.1mm, as drawn, 99.95%

GF26290313

Platinum, tube, 50mm, outside diameter 2.0mm, inside diameter 1.6mm, wall thickness 0.2mm, as drawn, 99.95%

GF22018553

Platinum, tube, 50mm, outside diameter 3.0mm, inside diameter 2.8mm, wall thickness 0.1mm, as drawn, 99.95%

GF72566657

Platinum, foil, 0.1m coil, thickness 0.029mm, coil width .34mm, annealed, 99.99%

GF06396532

Platinum, foil, 10mm disks, thickness 0.025mm, as rolled, 99.99+%

GF01692952

Platinum, wire reel, 0.05m, diameter 0.25mm, as drawn, 99.998%

GF41572414

Platinum, foil, 8mm disks, thickness 0.0075mm, as rolled, 99.95%

GF89210336

Platinum, foil, 4mm disks, thickness 0.025mm, as rolled, 99.95%

GF25102897

Platinum, foil, 0.5m coil, thickness 0.045mm, coil width .75mm, as rolled, 99.95%

GF88232542

Platinum, foil, 15mm disks, thickness 0.025mm, as rolled, 99.95%

GF87506208

Platinum, foil, 0.2m coil, thickness 0.025mm, coil width 1.6mm, as rolled, 99.95%

GF74454824

Platinum, wire reel, 0.1m, diameter 0.006mm, wollaston, 99.9%

GF87499906

Platinum, foil, 6mm disks, thickness 0.004mm, as rolled, 99.95%

GF99566410

Platinum, foil, 15mm disks, thickness 0.025mm, as rolled, 99.99+%

GF85102837

Platinum, wire reel, 0.1m, diameter 0.125mm, annealed, may be used as one component of a thermocouple, 99.99%

GF07973961

Platinum, foil, 0.5m coil, thickness 0.025mm, coil width .85mm, as rolled, 99.95%

GF52591462

Platinum, foil, 4mm disks, thickness 0.0075mm, as rolled, 99.95%