Adjuvant chemotherapy with Vinorelbine plus Cisplatin ( VC ) improves survival in resected non-small-cell lung cancer ( NSCLC ), but has negative impact on quality of life ( QoL ).
In advanced NSCLC, Gemcitabine plus Cisplatin ( GC ) and Docetaxel plus Cisplatin ( DC ) exhibit comparable efficacy, with possibly superior QoL compared to Vinorelbine plus Cisplatin.
This trial investigated these regimens in the adjuvant setting.

Patients with stage IB to III NSCLC were eligible following standardized surgery. Overall, 136 patients were included, with 67 and 69 assigned to the Gemcitabine plus Cisplatin and Docetaxel plus Cisplatin arms, respectively.
Cisplatin ( 75 mg/m2, Day [D] 1 ) plus Gemcitabine ( 1250 mg/m2, D1 and D8 ) or Docetaxel ( 75 mg/m2 D1 ) were administered for three cycles.

Primary end-point was QoL ( EORTC QLQ-C30 ), with the study designed to detect a 10-point difference between arms. Overall survival, safety and cost were secondary end-points.

No between-group imbalance was observed in terms of patient characteristics.

At inclusion, global health status ( GHS ) scores ( /100 ) were 63.5 and 62.7 in Gemcitabine plus Cisplatin and Docetaxel plus Cisplatin, respectively ( P = 0.8 ), improving to 64.5 and 65.4 after 3 months ( P = 0.8 ).

No significant difference in functional or symptoms scores was observed between the arms except for alopecia.

Grade 3/4 haematological and non-haematological toxicities were found in 33.8 and 21.7% ( P = 0.11 ), and 33.8 and 26.1% ( P = 0.33 ) of patients, in Gemcitabine plus Cisplatin and Docetaxel plus Cisplatin, respectively.

At 2 years, 92.9 and 89.8% of patients remained alive in Gemcitabine plus Cisplatin and Docetaxel plus Cisplatin, respectively ( P = 0.88 ).

In conclusion, Docetaxel plus Cisplatin and Gemcitabine plus Cisplatin adjuvant chemotherapies for completely resected non-small-cell lung cancer were well tolerated and appear free of major QoL effects, and are therefore representing candidates for comparison with the standard Vinorelbine plus Cisplatin regimen. ( Xagena )

Barlesi F et al, Interact Cardiovasc Thorac Surg 2015; Epub ahead of print

XagenaMedicine2015