Randomized multicenter phase II study of larotaxel (XRP9881) in combination with cisplatin or gemcitabine as first-line chemotherapy in nonirradiable stage IIIB or stage IV non-small cell lung cancer

Introduction: This randomized phase II study investigated the efficacy and safety of a new taxane, larotaxel (XRP9881), in combination with either cisplatin or gemcitabine in the first-line treatment of patients with nonirradiable stage IIIB or stage IV non-small cell lung cancer to select the combination having the most promising antitumor activity. Methods: Patients received either larotaxel (50 mg/m(2)) as a 1-hour infusion, followed by a 1-hour infusion of cisplatin (75 mg/m(2)), every 3 weeks (arm A), or gemcitabine (800 mg/m(2)) as a 30 minute infusion, on days 1 and 8, and larotaxel (60 mg/m(2)) as a 1-hour infusion, on day 8 (following gemcitabine), every 3 weeks (ann 13). The primary end point was the objective response rate (per-protocol Population). Results: Thirty-two patients were randomized to arm A and 30 to arm B. The response rate was higher in arm A compared with arm B in both the per-protocol (26.7% versus 18.2%) and intention-to-treat (28.1% versus 13.3%) populations. In the intention-to-treat population, median progression-free Survival for arm A versus arm B was 4.7 versus 3.3 months and median overall Survival was 8.6 versus 7.3 months, respectively. Fifty percent of patients in arm A and 66.7% in arm B experienced at least one National Cancer Institute common toxicity criteria grade 3/4 adverse event and grade 3/4 neutropenia was observed in 46.9% and 41.4% of patients, respectively. Conclusions: Both larotaxel combinations were effective and manageable, however all measured efficacy parameters (response rate, progression free survival, and survival) seemed to favor the combination with cisplatin.