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The impacts of race and regimens on the efficacy and safety of paclitaxel and platinum combination treatment for patients with advanced non-small cell lung cancer

  • Pharmacodynamics
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European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

Paclitaxel-platinum chemotherapy is the first-line treatment for advanced non-small cell lung cancer (NSCLC) patients. This study quantitatively evaluated the factors influencing the efficacy and safety of the paclitaxel-platinum regimen to provide the necessary reference for the development of clinical practice and clinical trials.

Methods

A literature search was performed using public databases. The parametric survival function was used to analyze the overall survival (OS) time course of patients treated with the paclitaxel-platinum regimen. The random effects model in the single-arm meta-analysis was used to analyze the objective response rate (ORR) and the incidence of grade 3–4 adverse events (AEs) under the predefined subgroups according to race and the regimen.

Results

A total of 31 studies consisting of 3365 participants were included in the analysis. Race was the most important determinant of efficacy and safety in the paclitaxel-platinum regimen, with the median survival time and ORR in East Asians and non-East Asians being 12.2 months (95% CI: 10.5–14.4 months) and 37% (95% CI: 32–41%) and 8.4 months (95% CI: 6.5–11.0 months) and 28% (95% CI: 25–32%), respectively. The incidence of grade 3–4 AEs such as leukopenia and neutropenia was about three times higher in East Asians compared to non-East Asians.

Conclusions

The efficacy and safety of the paclitaxel-platinum regimen can vary between East Asian and non-East Asian populations and between different treatment schedules. The results of this study can provide a reliable and precise external control for the future evaluation of new treatment options for advanced NSCLC.

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Availability of data and material

All data generated or analyzed during this study are included in this published article and its supplementary information files.

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Funding

This study was provided by the project of Shanghai S&T Innovation Plan (17401970900) and National Major S&T Project (2018ZX09734005, 2018ZX09711001-009-011, 2018ZX09731016, 2017ZX09304003, and 2018ZX10303501).

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Authors and Affiliations

  1. Center for Drug Clinical Evaluation, Shanghai University of Traditional Chinese Medicine, Shanghai, China

    Chenyang Zhao, Fengli Wang, Jihan Huang, Yinghua Lv, Fang Yin, Hongxia Liu, Qingshan Zheng & Lujin Li

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  1. Chenyang Zhao
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  2. Fengli Wang
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  3. Jihan Huang
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  4. Yinghua Lv
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  5. Fang Yin
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  6. Hongxia Liu
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  7. Qingshan Zheng
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  8. Lujin Li
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Contributions

ZCY collected the data, performed the analyses, interpreted the data, and drafted the manuscript. ZQS, LHX, LLJ, HJH, LYH, and YF supervised the analyses and reviewed the manuscript. WFL participated in data collection. All authors contributed to manuscript revision and have read and approved the submitted version.

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Correspondence to Qingshan Zheng or Lujin Li.

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Zhao, C., Wang, F., Huang, J. et al. The impacts of race and regimens on the efficacy and safety of paclitaxel and platinum combination treatment for patients with advanced non-small cell lung cancer. Eur J Clin Pharmacol 77, 685–695 (2021). https://doi.org/10.1007/s00228-021-03129-6

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