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Meta-analysis of docetaxel-based doublet versus docetaxel alone as second-line treatment for advanced non-small-cell lung cancer

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Abstract

Purpose

To compare docetaxel-based doublet with single-agent docetaxel as second-line treatment in non-small-cell lung cancer (NSCLC).

Methods

We systematically searched for randomized clinical trials that compared docetaxel-based doublet with single-agent docetaxel in patients with histologically proven non-small-cell lung cancer. The primary end point was overall survival (OS). Secondary end points were progression-free survival, overall response rate, 1-year survival rate, and grade 3 or 4 toxicity. Data were extracted from the studies by two independent reviewers. The meta-analysis was performed by Stata version 10.0 software (Stata Corporation, College Station, TX, USA).

Results

Eight randomized clinical trials (totally 2,126 patients) were eligible. Meta-analysis showed that there was significant improvement in PFS (HR 0.81, 95% CI 0.69–0.96, P = 0.013) and overall response rate (OR 1.42, 95% CI 1.13–1.80, P = 0.03) in docetaxel-based doublet group, compared with docetaxel alone, though the pooled HR for overall survival (HR 0.93, 95% CI 0.80–1.07, P = 0.308) showed no significant difference between the two groups. However, there were more incidences of grade 3 or 4 neutropenia (OR 1.2, 95% CI 1.00–1.45, P = 0.05), thrombocytopenia (OR 4.53, 95% CI 1.75–11.75, P = 0.002), and diarrhea (OR 1.78, 95% CI 1.16–2.74, P = 0.008) in docetaxel-based doublet group. With regard to the risk of grade 3 or 4 anemia (OR 1.95, 95% CI 0.62–6.17, P = 0.25), fatigue (OR 1.09, 95% CI 0.75–1.59, P = 0.66), and nausea and vomiting (OR 1.75, 95% CI 0.78–3.91, P = 0.17), there was no significant difference between the two groups.

Conclusions

This was the first meta-analysis of docetaxel-based doublet versus single-agent docetaxel as second-line therapy in the treatment of non-small-cell lung cancer. The results indicated that docetaxel-based doublet therapy did not gain any benefit in survival but significantly improved PFS and better ORR versus single-agent docetaxel. However, more incidences of grade 3 or 4 neutropenia, thrombocytopenia, and diarrhea were observed in docetaxel-based doublet group.

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Authors and Affiliations

  1. Department of Oncology, The Sixth People Hospital, Medical College of Shanghai Jiao Tong University, Shanghai, 200233, China

    Wei-Xiang Qi, Zan Shen & Yang Yao

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  1. Wei-Xiang Qi
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  2. Zan Shen
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Correspondence to Yang Yao.

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Qi, WX., Shen, Z. & Yao, Y. Meta-analysis of docetaxel-based doublet versus docetaxel alone as second-line treatment for advanced non-small-cell lung cancer. Cancer Chemother Pharmacol 69, 99–106 (2012). https://doi.org/10.1007/s00280-011-1678-9

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  • DOI: https://doi.org/10.1007/s00280-011-1678-9

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