comparing docetaxel plus cisplatin with paclitaxel plus carboplatin in chemotherapy-naïve patients with advanced non-small-cell lung cancer: a single institute study

aims: the backbone of treatment in advanced non-small cell lung cancer is platinum-based doublet chemotherapy. we intended to compare the effectiveness of two commonly used regimens in real world practice. methods: this single institute, parallel comparative post marketing study included 100 patients with chemo-naïve advanced (stage iiib, iv) non-small cell lung cancer and eastern cooperative oncology group performance status of 0 to 2. they were randomly assigned by stratified blocks to receive docetaxel/cisplatin (dc, n=50) on day 1 or paclitaxel/carboplatin auc 5 (pc, n=50) on day 1, every 3 weeks for up to six cycles. primary end point was progression free survival (pfs); secondary end points were objective response rate, overall survival (os) and toxicity. the administered dosage could be modified according to clinician’s discretion for each individual patient. results: pfs was similar between dc and pc arms (4.5±0.3 v 4.6±1.8 months, respectively; hr= 1.337; 95% ci: 0.874 to 2.046, p= 0.181). although median overall survival for dc arm was longer (17.2±4.4 m) than pc arm (10.6±0.7 m) but was not statistically significant (p=0.300). the 1-year survival rates were in favor of dc arm (53.1% v 37.9%). objective response rates were similar in both groups. in our study, hematologic toxicity and neuropathy were more frequent in dc and pc arms, respectively. conclusion: in our study two commonly used regimens of dc and pc showed statistically similar outcomes in terms of pfs and os, albeit numerically results of os and 1-year survival were in favor of dc arm.