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Lung cancer highlights

T J Lynch1

  • 1Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114-2617, USA. lynch.thomas@mbh.harvard.edu

The Oncologist
|August 31, 2000
PubMed

Insights

Despite comparing four platinum-based doublets in advanced non-small cell lung cancer (NSCLC), ECOG 1594 showed no survival improvements. However, novel agents targeting EGFR and VEGF show promise for future NSCLC treatment.

Area of Science:

  • Medical Oncology
  • Clinical Trials
  • Cancer Research

Background:

  • Assessing treatment progress for advanced non-small cell lung cancer (NSCLC) over 15 years.
  • Evaluating the Eastern Cooperative Oncology Group (ECOG) 1594 trial comparing four platinum-based doublets in metastatic lung cancer.
  • Dr. Francis Shepherd's commentary on the "snail's pace" of progress in metastatic lung cancer treatment.

Framework:

  • ECOG 1594: A large randomized trial comparing four platinum-based doublet regimens.
  • Primary endpoint: Survival. Secondary endpoint: Response and time to progression.
  • Analysis of survival, response, and time to progression across treatment arms.

Implementation:

  • No significant differences in survival or response were observed between the four regimens.
  • The cisplatin/gemcitabine arm demonstrated a superior time to progression.
  • Results presented at the 36th Annual Meeting of the American Society of Clinical Oncology (ASCO).

Implications:

  • Limited progress in standard chemotherapy for advanced NSCLC based on ECOG 1594.
  • Emerging novel agents, including Iressa (anti-epidermal growth factor receptor tyrosine kinase) and anti-vascular endothelial growth factor monoclonal antibodies, show potential.
  • Cisplatin/irinotecan combination demonstrated superiority over cisplatin/etoposide in small-cell lung cancer, suggesting new therapeutic avenues.

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