Clinical and cost effectiveness of paclitaxel, docetaxel, gemcitabine, and vinorelbine in non-small cell lung cancer: a systematic review

Clegg, A.; Scott, D. A.; Hewitson, P.; Sidhu, M.; Waugh, N.
January 2002
Thorax;Jan2002, Vol. 57 Issue 1, p20
Academic Journal
Background: Lung cancer remains a devastating disease with few effective treatment options. Recent developments in chemotherapy have led to cautious optimism. This paper reviews the evidence on the clinical and cost effectiveness of four of the new generation drugs for patients with lung cancer. Methods: A systematic review of randomized controlled trials (RCTs) identified from 11 electronic databases (including Medline, Cochrane library and Embase), reference lists and contact with experts and industry was performed to assess clinical effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine. Clinical effectiveness was assessed using the outcomes of patient survival, quality of life, and adverse effects. Cost effectiveness was assessed by development of a costing model and presented as incremental cost per life year saved (LYS) compared with best supportive care (BSC). Results: Of the 33 RCTs included, five were judged to be of good quality, 10 of adequate quality, and 1 8 of poor quality. Gemcitabine, paclitaxel, and vinorelbine as first line treatment and docetaxel as second line treatment appear to be more beneficial for non-small cell lung cancer than BSC and older chemotherapy agents, increasing patient survival by 2-4 months a9ainst BSC and some comparator regimes. These gains in survival do not appear to be at the expense of quality of life. Survival gains were delivered at reasonable levels of incremental cost effectiveness for vinorelbine, vinorelbine with cisplatin, gemcitabine, gemcitabine with cisplatin, and paclitaxel with cisplatin regimens compared with BSC. Conclusion: Although the clinical benefits of the new drugs appear relatively small, their benefit to patients with lung cancer appears to be worthwhile and cost effective.


Related Articles

  • Adding bevacizumab to second-line erlotinib did not improve OS in NSCLC.  // Hem/Onc Today;12/10/2008, Vol. 9 Issue 22, p15 

    The article reports on the findings of a clinical trial which showed the effectiveness of bevacizumab combined with erlotinib in improving overall survival (OS) during treatment of non-small cell lung cancer (NSCLC). Study results presented by Roy S. Herbst of The University of Texas M.D....

  • Cetuximab plus chemoradiation safe, active in advanced NSCLC.  // Hem/Onc Today;12/10/2008, Vol. 9 Issue 22, p16 

    The article reports on the findings of a phase-2 trial regarding the effectiveness of and safety in using a combined cetuximab and chemoradiation in the treatment of patients with non-small cell lung cancer (NSCLC). A total of 93 patients participated in the study. Initially they received...

  • A phase 1 study of linifanib in combination with carboplatin/paclitaxel as first-line treatment of Japanese patients with advanced or metastatic non-small cell lung cancer (NSCLC). Horinouchi, Hidehito; Yamamoto, Noboru; Nokihara, Hiroshi; Horai, Takeshi; Nishio, Makoto; Ohyanagi, Fumiyoshi; Horiike, Atsushi; Nakagawa, Kazuhiko; Terashima, Masaaki; Okabe, Takafumi; Kaneda, Hiroyasu; McKee, Mark; Carlson, Dawn; Xiong, Hao; Tamura, Tomohide // Cancer Chemotherapy & Pharmacology;Jul2014, Vol. 74 Issue 1, p37 

    Introduction: Linifanib is a potent, orally active, and selective inhibitor of vascular endothelial growth factor and platelet-derived growth factor receptor kinase activities with clinical efficacy in non-small cell lung cancer (NSCLC). This phase 1 dose-escalation study evaluated the...

  • Second-line chemotherapy with weekly paclitaxel and gemcitabine in patients with small-cell lung cancer pretreated with platinum and etoposide: a single institution phase II trial. Dongiovanni, Vincenzo; Buffoni, Lucio; Berruti, Alfredo; Dongiovanni, Diego; Grillo, Raffaella; Barone, Carla; Addeo, Alfredo; Fissore, Camilla; Bertetto, Oscar // Cancer Chemotherapy & Pharmacology;Aug2006, Vol. 58 Issue 2, p203 

    Purpose: The safety and efficacy of a combined regimen of weekly paclitaxel and gemcitabine was tested in patients with refractory and sensitive small-cell lung cancer (SCLC). Methods: Treatment consisted of paclitaxel 80 mg/m2 on days 1, 8, 15 and gemcitabine 1,000 mg/m2 on days 1 and 8 every 3...

  • Lenograstim + chemo for SCLC: cost effectiveness "finely balanced.".  // PharmacoEconomics & Outcomes News;6/17/2006, Issue 505, p9 

    The article discusses research being done on the cost effectiveness of increasing the dose intensity of chemotherapy with granulocyte colony-stimulating factor in small-cell lung cancer (SCLC). It references a study by L. Bojke and colleagues in the April 15, 2006 issue of "PharmacoEconomics."...

  • Gefitinib: A Review of its Use in the Treatment of Locally Advanced/Metastatic Non-Small Cell Lung Cancer. Sanford, Mark; Scott, Lesley J. // Drugs;2009, Vol. 69 Issue 16, p2303 

    Gefitinib (lressaâ„¢) is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor that offers treatment for patients with locally advanced or metastatic non-small cell lung cancer (NSCLC), in particular in those who are harbouring EGFR mutations. In a large phase III trial...

  • Clinical setbacks for toll-like receptor 9 agonists in cancer. Schmidt, Charlie // Nature Biotechnology;Aug2007, Vol. 25 Issue 8, p825 

    The article discusses the decision by pharmaceutical company Pfizer to suspend a clinical program researching a drug for non-small cell lung cancer. The article describes how the drug PF-3512676, a CpG oligodeoxynucleotide (ODN) drug, was designed to actuate toll-like receptor-9 (TLR9) of the...

  • American Society of Clinical Oncology.  // BioWorld Today;6/3/2009, Vol. 20 Issue 105, p5 

    The article highlights a monotherapy clinical trial of hypoxia-activated prodrug TH-302 presented by Threshold Pharmaceuticals Inc. at the 2009 American Society of Clinical Oncology (ASCO) annual meeting. Key findings indicated that the prodrug showed a positive safety profile with minimal proof...

  • Surgery in limited-disease small-cell lung cancer. Koul, Parvaiz A. // Lung India;Jan-Mar2012, Vol. 29 Issue 1, p2 

    The author reflects on the abandonment of surgery as a treatment of choice for patients with limited-disease small-cell lung cancer (LD-SCLC) due to the result of a randomized trial which revealed a survival difference between surgery and radiotherapy. An overview of some studies which show that...


Read the Article


Sign out of this library

Other Topics