AsianScientist (Jun. 1, 2011) – Analysis of 1975-2010 trial data shows that Asian non-small cell lung cancer (NSCLC) patients survive longer than Caucasians no matter how many drugs are given in a first-line setting, according to research published in the Journal of Thoracic Oncology.
“It is recognized Asian patients with a common type of lung cancer, the non-small cell type, have a better survival than Caucasian patients when treated with chemotherapy,” said Dr. Ross Soo, senior consultant in the Department of Haematology-Oncology at the National University Hospital in Singapore.
“What wasn’t known previously was whether this effect was seen in patients given just one or a combination of drugs.”
Soo and colleagues analyzed studies published in the past 35 years in which chemotherapy was given to patients in the advanced stage, and they found Asian patients had a longer survival and also a higher chance of tumor shrinkage regardless of the number of chemotherapy drugs given in the first-line setting.
They also found Asian patients lived longer than Caucasian patients in the era both before and after the use of targeted therapy such as gefitinib and erlotinib. These findings may impact on the design and conduct of international lung cancer trials as more Asian countries are now participating in such studies.
Based on 191 randomized controlled trials published between 1975 and 2010 involving 48,369 patients (6,806 Asian and 41,563 white), Asian patients survived for 10.1 months on average while white patients’ survived for 8 months.
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib were introduced in many Asian countries in 2002, and their use was associated with an improvement in survival rate of Asian patients. In the pre-gefitinib and erlotinib years, median survival rate was 9.1 months for Asians and 7.3 months for whites; from 2002 onward that gap widened to 11.0 months for Asians and 8.9 months for whites.
In monotherapy studies done since 2002, the median survival rate was significantly higher in Asian than in white studies: 11.8 vs. 7.1 months. It also was notably higher than the years prior to 2002, when survival rate was 8.9 months for Asian and 6.5 months for white patients.
In platinum doublets the median survival rate was 11.0 months for Asians and 9.5 months for whites; that compared with pre-2002 survival rates of 9.1 months for Asian and 7.6 months for white patients. For regimens of three drugs or more, post EGFR TKI-approval median survival rate was 9.5 months for Asians and 8.2 months for whites, compared with 9.3 and 7.6 months, respectively, before 2002.
Based on this study, the researchers conclude that ethnic differences in survival and response rate to chemotherapy exist. They recommend that these differences should be considered in clinical trial designs especially in the global context.
The article can be found at: Soo R et al. (2011) Ethnic Differences in Survival Outcome in Patients with Advanced Stage Non-small Cell Lung Cancer: Results of a Meta-Analysis of Randomized Controlled Trials.
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Source: International Association for the Study of Lung Cancer.
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