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.