Key Point

Retrospective study findings demonstrate a significant improvement in survival time among patients with non-small cell lung cancer over the last decade-indicating considerable progress in the palliative treatment of non-small cell lung cancer.

BASEL, SWITZERLAND—Significant progress has been made in the palliative treatment of non-small cell lung cancer in the last decade, according to Frank Waechter and colleagues. In particular, third-generation cytotoxic drugs have had a positive impact on survival time.¹

Mr. Waechter, of the University Hospital of Basel in Switzerland, and his colleagues analyzed data on 230 patients treated at that hospital after 1990 for non-small cell lung cancer. Outcomes of patients diagnosed before 1997 were compared with those of patients diagnosed since 1997.

According to the researchers, 65.2% of the 230 patients had stage IV disease, 21.3% had stage IIIB disease, 8.3% had stage IIIA disease, 3% had stage II disease, and 2.2% had stage I disease. Furthermore, 56.1% of patients had adenocarcinomas, 23% had squamous cell cancers, and 15.7% had large cell cancers.

Thirty-one patients received best supportive care only, whereas 199 were treated with palliative chemotherapy. Of the patients treated with chemotherapy, 138 received one of the newer cytotoxic drugs (vinorelbine, gemcitabine, docetaxel, or paclitaxel, with or without a platinum agent); 44 received another type of chemotherapy, and 17 were treated with an experimental drug. Fifty-eight patients received a second-line drug for palliative chemotherapy.

The researchers found that one- and two-year survival rates of patients diagnosed since 1997 were significantly better-improving by 20%-than those of patients diagnosed prior to 1997. Increased survival since 1997 was associated with improvements in best supportive care, in first-line chemotherapy, and in second-line chemotherapy. One notable finding was that patients who received third-generation cytotoxic drugs plus a platinum agent had significantly better survival time than patients treated with an older therapy regimen.

According to the researchers, their results are in line with those of several prospective randomized trials involving a select group of patients with non-small cell lung cancer, which suggested that third-generation cytotoxic agents improve survival time. They expressed confidence that the knowledge gained in these trials is “applicable to a wider patient population that is typically found in a general oncology outpatient clinic.” But they cautioned that due to the retrospective nature of their study, “the results concerning clinical benefit, objective response rate, and quality of life are incomplete, and should not be overinterpreted.”

—Karen L. Spittler

Reference
1. Waechter F, Passweg J, Tamm M, et al. Significant progress in palliative treatment of non-small cell lung cancer in the past decade. Chest. 2005;127:738-747.

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