Docetaxel/platinum in advanced non-small-cell lung cancer: recent randomized trials

The role of docetaxel-containing doublets as first-line chemotherapy for patients with advanced and metastatic non-small-cell lung cancer (NSCLC) was evaluated in a large randomized trial. Docetaxel/cisplatin and docetaxel/carboplatin were compared with the reference regimen of vinorelbine/cisplatin. After adjustment for imbalances in prognostic factors, the overall survival of patients treated with docetaxel/cisplatin was significantly better than that of patients treated with vinorelbine/cisplatin, the reference regimen. Survival for patients on the docetaxel/carboplatin arm was noninferior to the same reference regimen. The major grade 3/4 hematologic toxicity was neutropenia, which affected approximately three fourths of the participants. Overall, the docetaxel/platinum arms were well tolerated. Both docetaxel/carboplatin and docetaxel/cisplatin appear to be effective first-line chemotherapy combinations for advanced NSCLC and are efficacious treatment options in this setting. The future of NSCLC therapy might lie in the development of novel treatment paradigms that involve the integration of targeted agents with traditional cytotoxic chemotherapy.