Weekly versus Three Weekly Regimens of Taxanes for Non-Small Cell Lung Cancer: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

1. Evidence-Based Medicine Center of Lanzhou University, Lanzhou 73000, China;2. Department of Oncology, General Hospital of Tianjin Medical University, Tianjin 300052, China;

Corresponding author：

Keywords：

Paclitaxel; Docetaxel; Non-small cell lung cancer; Randomized controlled trial; Meta analysis; Systematic review

DOI：

10.7507/1672-2531.20100456

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Objective 　To determine the effectiveness and safety of weekly versus three weekly regimens of taxanes for non-small cell lung cancer (NSCLC).
Methods 　We searched The Cochrane Library (Issue 1, 2008), PubMed (1966 to May 2008), EMbase (1974 to May 2008), and CBM (1978 to May 2008) to identify randomized controlled trials (RCTs) which compared weekly and three weekly regimens of taxanes for NSCLC. Data collection was undertaken by two reviewers independently; the methodological quality was assessed according to the Cochrane Handbook 4.2.6; and the meta-analyses were performed using RevMan 5.0 software.
Results 　Nine RCTs involving 1 438 patients were included. The results of meta-analyses showed: (1) There were no significant differences in the efficacy between weekly and three weekly regimens of taxanes regarding the one-year survival rate (paclitaxel: RR=1.24, 95%CI 0.83 to 1.86; docetaxel: RR=0.80, 95%CI 0.51 to 1.23) and the overall response rate (paclitaxel: RR=1.03, 95%CI 0.72 to 1.49; docetaxel: RR=0.98 95%CI 0.64 to 1.49). (2) The incidence of neutropenia was less serious in the weekly group (paclitaxel: RR=0.74, 95%CI 0.56 to 0.97; docetaxel: RR=0.22, 95%CI 0.16 to 0.30), while no significant differences existed in other adverse effects such as anemia and nausea/vomiting.
Conclusion 　The efficacy of weekly and three weekly regimens of taxanes for the treatment of NSCLC is similar. The incidence of neutropenia is lower in the weekly group while other toxicities show no differences.

Citation： SHAO Yi,MA Li,MA Bin,TIAN JinHui,YANG KeHu. Weekly versus Three Weekly Regimens of Taxanes for Non-Small Cell Lung Cancer: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2010, 10(5): 602-608. doi: 10.7507/1672-2531.20100456 Copy

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4.	Noble J, Ellis PM, Mackay JA, et al. Second-line or subsequent systemic therapy for recurrent or progressive non-small cell lung cancer: a systematic review and practice guideline. J Thorac Oncol, 2006, 1(9): 1042-1058.
5.	Shepherd FA, Dancey J, Ramlau R, et al. Prospective randomized trial of docetaxel versus best supportive care in patients with nonsmall- cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol, 2000, 18(10): 2095-2103.
6.	Fossella FV, DeVore R, Kerr RN, et al. Randomized phase III trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small-cell lung cancer previously treated with platinumcontaining chemotherapy regimens: The TAX 320 Non-Small Cell Lung Cancer Study Group. J Clin Oncol, 2000, 18(12): 2354-2362.
7.	von Pawel J, Wagner H, Niederle N, et al. Phase II study of paclitaxel and cisplatin in patients with non-small cell lung cancer. Semin Oncol, 1996, 23(6 Suppl 16): 47-50.
8.	Nakamura Y, Kunitoh H, Kubota K, et al. Retrospective analysis of safety and efficacy of low-dose docetaxel 60 mg/m2 in advanced non-small cell lung cancer patients previously treated with platinum- based chemotherapy. Am J Clin Oncol, 2003, 26(5): 459-464.
9.	Seidman AD, Hudis CA, Albanel J, et al. Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer . J Clin Oncol, 1998, 16(10) : 3353-3361.
10.	Lilenbaum RC, Schwartz MA, Seigel L, et al. Phase II trial of weekly docetaxel in second-line therapy for non-small cell lung carcinoma. Cancer, 2001, 92(8): 2158-2163.
11.	Belani CP, Dakhil S, Waterhouse DM, et al. Randomized phase II trial of gemcitabine plus weekly versus three-weekly paclitaxel in previously untreated advanced non-small-cell lung cancer. Ann Oncol, 2007, 18(1): 110-115.
12.	Socinski MA, Ivanova A, Bakri K, et al. A randomized phase II trial comparing every 3-weeks carboplatin/paclitaxel with every 3-weeks carboplatin and weekly paclitaxel in advanced non-small cell lung cancer. Ann Oncol, 2006, 17(1): 104-109.
13.	Camps C, Massuti B, Jiménez A, et al. Randomized phase III study of 3-weekly versus weekly docetaxel in pretreated advanced nonsmall- cell lung cancer: a Spanish Lung Cancer Group trial. Ann Oncol, 2006, 17(3): 467-472.
14.	Chen YM, Shih JF, Perng RP, et al. A randomized trial of different docetaxel schedules in non-small cell lung cancer patients who failed previous platinum-based chemotherapy. Chest, 2006, 129(4): 1031-1038.
15.	Gervais R, Ducolone A, Breton JL, et al. Phase II randomized trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC). Ann Oncol, 2005, 16(1): 90-96.
16.	Gridelli C, Gallo C, Di Maio M, et al. A randomised clinical trial of two docetaxel regimens (weekly vs 3 week) in the second-line treatment of non-small-cell lung cancer. The DISTAL01 study. Br J Cancer, 2004, 91(12): 1996-2004.
17.	Lai CL, Tsai CM, Chiu CH, et al. Phase II randomized trial of triweekly versus days 1 and 8 weekly docetaxel as a second-line treatment of advanced non-small cell lung cancer. Jpn J Clin Oncol, 2005, 35(12): 700-706.
18.	Schuette W, Nagel S, Blankenburg T, et al. Phase III study of secondline chemotherapy for advanced non-small-cell lung cancer with weekly compared with 3-weekly docetaxel. J Clin Oncol, 2005, 23(33): 8389-8395.
19.	Lilenbaum R, Rubin M, Samuel J, et al. A randomized phase II trial of two schedules of docetaxel in elderly or poor performance status patients with advanced non-small cell lung cancer. J Thorac Oncol, 2007, 2(4): 306-311.
20.	Massimo DM, Francesco P, Paolo C, et al. Individual patient data meta-analysis of docetaxel administered once every 3 weeks compared with once every week second-line treatment of advanced nonsmall- cell lung cancer. J Clin Oncol, 2007 25(11): 1377-1382.

1. Parkin DM, Bray FI, Devessa SS. Cancer burden for the year 2000: the global picture. Eur J Cancer, 2001, 37(Suppl 8): S4-S66.
2. American Cancer Society: Cancer facts and figures 2008. [2008- 07-20]. http: //www.cancer.org/.
3. Non-small lung cancer Collaborative Group. Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomized clinical trials. BMJ, 1995, 311(7010): 899-909.
4. Noble J, Ellis PM, Mackay JA, et al. Second-line or subsequent systemic therapy for recurrent or progressive non-small cell lung cancer: a systematic review and practice guideline. J Thorac Oncol, 2006, 1(9): 1042-1058.
5. Shepherd FA, Dancey J, Ramlau R, et al. Prospective randomized trial of docetaxel versus best supportive care in patients with nonsmall- cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol, 2000, 18(10): 2095-2103.
6. Fossella FV, DeVore R, Kerr RN, et al. Randomized phase III trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small-cell lung cancer previously treated with platinumcontaining chemotherapy regimens: The TAX 320 Non-Small Cell Lung Cancer Study Group. J Clin Oncol, 2000, 18(12): 2354-2362.
7. von Pawel J, Wagner H, Niederle N, et al. Phase II study of paclitaxel and cisplatin in patients with non-small cell lung cancer. Semin Oncol, 1996, 23(6 Suppl 16): 47-50.
8. Nakamura Y, Kunitoh H, Kubota K, et al. Retrospective analysis of safety and efficacy of low-dose docetaxel 60 mg/m2 in advanced non-small cell lung cancer patients previously treated with platinum- based chemotherapy. Am J Clin Oncol, 2003, 26(5): 459-464.
9. Seidman AD, Hudis CA, Albanel J, et al. Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer . J Clin Oncol, 1998, 16(10) : 3353-3361.
10. Lilenbaum RC, Schwartz MA, Seigel L, et al. Phase II trial of weekly docetaxel in second-line therapy for non-small cell lung carcinoma. Cancer, 2001, 92(8): 2158-2163.
11. Belani CP, Dakhil S, Waterhouse DM, et al. Randomized phase II trial of gemcitabine plus weekly versus three-weekly paclitaxel in previously untreated advanced non-small-cell lung cancer. Ann Oncol, 2007, 18(1): 110-115.
12. Socinski MA, Ivanova A, Bakri K, et al. A randomized phase II trial comparing every 3-weeks carboplatin/paclitaxel with every 3-weeks carboplatin and weekly paclitaxel in advanced non-small cell lung cancer. Ann Oncol, 2006, 17(1): 104-109.
13. Camps C, Massuti B, Jiménez A, et al. Randomized phase III study of 3-weekly versus weekly docetaxel in pretreated advanced nonsmall- cell lung cancer: a Spanish Lung Cancer Group trial. Ann Oncol, 2006, 17(3): 467-472.
14. Chen YM, Shih JF, Perng RP, et al. A randomized trial of different docetaxel schedules in non-small cell lung cancer patients who failed previous platinum-based chemotherapy. Chest, 2006, 129(4): 1031-1038.
15. Gervais R, Ducolone A, Breton JL, et al. Phase II randomized trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC). Ann Oncol, 2005, 16(1): 90-96.
16. Gridelli C, Gallo C, Di Maio M, et al. A randomised clinical trial of two docetaxel regimens (weekly vs 3 week) in the second-line treatment of non-small-cell lung cancer. The DISTAL01 study. Br J Cancer, 2004, 91(12): 1996-2004.
17. Lai CL, Tsai CM, Chiu CH, et al. Phase II randomized trial of triweekly versus days 1 and 8 weekly docetaxel as a second-line treatment of advanced non-small cell lung cancer. Jpn J Clin Oncol, 2005, 35(12): 700-706.
18. Schuette W, Nagel S, Blankenburg T, et al. Phase III study of secondline chemotherapy for advanced non-small-cell lung cancer with weekly compared with 3-weekly docetaxel. J Clin Oncol, 2005, 23(33): 8389-8395.
19. Lilenbaum R, Rubin M, Samuel J, et al. A randomized phase II trial of two schedules of docetaxel in elderly or poor performance status patients with advanced non-small cell lung cancer. J Thorac Oncol, 2007, 2(4): 306-311.
20. Massimo DM, Francesco P, Paolo C, et al. Individual patient data meta-analysis of docetaxel administered once every 3 weeks compared with once every week second-line treatment of advanced nonsmall- cell lung cancer. J Clin Oncol, 2007 25(11): 1377-1382.

Chinese Journal of Evidence-Based Medicine

Weekly versus Three Weekly Regimens of Taxanes for Non-Small Cell Lung Cancer: A Systematic Review

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