Cisplatin/etoposide vs paclitaxel/cisplatin/G-CSF vs paclitaxel/cisplatin in non-small-cell lung cancer

A phase III trial conducted by Eastern Cooperative Oncology Group (ECOG) investigators assessed the possible impact of paclitaxel on survival, response, and toxicity in patients with advanced non-small-cell lung cancer. Three regimens were compared: cisplatin/etoposide, paclitaxel/ cisplatin/granulocyte colony-stimulating factor (G-CSF), and paclitaxel/ cisplatin. Patients were randomly assigned to the regimens, each of which was repeated every 21 days over a 17-month period. Response rates were 12% in the cisplatin/etoposide group, 31% in the paclitaxel/cisplatin/G-CSF group, and 26% in the paclitaxel/cisplatin group. Significant differences in response were observed between the cisplatin/etoposide and paclitaxel/cisplatin/G-CSF groups and the cisplatin/etoposide and paclitaxel/cisplatin groups; there was no significant difference between patients treated with paclitaxel/cisplatin vs paclitaxel/cisplatin/G-CSF. Both paclitaxel regimens were associated with significantly higher response rates compared with etoposide/cisplatin. Based on preliminary survival analyses, the investigators concluded that the paclitaxel regimens may be associated with superior survival.