Factors affecting the efficacy and safety of docetaxel combined with platinum in the treatment of advanced non-small cell lung cancer

ABSTRACT

Background

This study aimed to quantitatively evaluate factors influencing the efficacy and safety of the docetaxel–platinum regimen to provide reliable information for optimizing chemotherapy regimens.

Research design and methods

A parametric survival function model was used to describe the time course of overall survival (OS) of patients with advanced non-small cell lung cancer (NSCLC) receiving a docetaxel–platinum regimen. A random-effects model in a single-arm meta-analysis was used to analyze the objective response rate and grade 3–4 adverse event rates based on various docetaxel–platinum regimens.

Results

The model revealed that the risk of death in East Asians was approximately 1.5-fold higher than that in non-East Asians, with a median OS of 13.7 (95% confidence interval [CI]: 12.8–14.7) months and 9.3 (95% CI: 7.7–11.1) months, respectively. No significant impact of different administration regimens on OS was found. However, when drug exposure increased, the incidence of grade 3–4 anemia or neutropenia significantly increased.

Conclusions

The docetaxel–platinum regimen has different efficacies in the treatment of advanced NSCLC between East Asian and non-East Asian populations. A better benefit–risk ratio can be obtained with a lower exposure regimen of docetaxel combined with platinum.

KEYWORDS:

• Docetaxel
• model-based meta-analysis
• non-small cell lung cancer
• platinum
• race

Acknowledgments

This study was supported by the project of Shanghai Municipal Health Planning Commission (2018YQ48) and National Major S&T Project (2018ZX09711001).

Disclosure Statement

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

FL.W and CY.Z selected studies and extracted the data, analyzed and interpreted the data, FL.W and LJ.L wrote the manuscript. FL.W and CY.Z contributed to data extraction and cleaning. LJ.L, X.W and QS.Z participated in conception and design of the work and revised the paper critically for important intellectual content. All authors read and approved the final manuscript.

Additional information

Funding

This paper received funding from the National Major S&T Project [2017ZX09304003, 2018ZX09711001-009-011, 2018ZX09731016, 2018ZX09734005, 2018ZX10303501] and Shanghai S&T Innovation Plan [17401970900].