Does Salvage Therapy Influence Outcome?
Authors: Corey J. Langer, Ulrich Gatzemeier, Gilles Gallant, Jan Bogaerts
Journal: Journal of Clinical Oncology (2001)

Article Tools SPECIAL DEPARTMENTS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2001.19.7.2108 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11283150 Does Salvage Therapy Influence Outcome? Corey J. LangerxCorey J. LangerSearch for articles by this author Ulrich GatzemeierxUlrich GatzemeierSearch for articles by this author , Gilles GallantxGilles GallantSearch for articles by this author , Jan BogaertsxJan BogaertsSearch for articles by this author Show More Thoracic Oncology, Fox Chase Cancer Center, Philadelphia, PAGrosshansdorf Hospital, Grosshansdorf, GermanyBristol-Meyers Squibb Pharmaceuticals Research Institute, Wallingford, CTBristol-Myers Squibb Pharmaceutical Research Institute, Waterloo, Belgium https://doi.org/10.1200/JCO.2001.19.7.2108 First Page Full Text PDF Figures and Tables © 2001 by American Society of Clinical OncologyjcoJ Clin OncolJournal of Clinical OncologyJCO0732-183X1527-7755American Society of Clinical OncologyResponse01042001In Reply:We sincerely thank Dr Langer for taking time to point out the importance of collecting and reviewing subsequent chemotherapy administration in patients with non–small-cell lung cancer who have received front-line chemotherapy for advanced disease. Because of space limitations in our original article,1 we did not include a table describing exactly which agents were administered to patients after completion of the study therapy. This table is presented here ( Table 1). Follow-Up Chemotherapy Follow-Up ChemotherapyType of Drug*No. of PatientsHigh-Dose Cisplatin (n = 76)Paclitaxel/Cisplatin (n = 57)*Patients may have received more than one chemotherapeutic agent.Vinorelbine3026Carboplatin208Etoposide1510Ifosfamide177Cisplatin810Gemcitabine116Mitomycin125Vindesine59Cyclophosphamide55Paclitaxel53Fluorouracil52Vincristine43Doxorubicin23Docetaxel40Vinblastine31Other agents68 As mentioned in the original article, among all randomized patients, a total of 76 patients (37%) in the high-dose cisplatin arm and 57 patients (28%) in the paclitaxel/cisplatin arm received subsequent chemotherapy.1 An a posteriori Fisher’s exact test suggest a borderline statistical significance (P = .058) between these numbers.The most frequently used second-line chemotherapy agents were vinorelbine, carboplatin, etoposide, ifosfamide, and cisplatin. As mentioned in the article, only a limited number of patients in both arms received a taxane as subsequent treatment (nine patients on the high-dose cisplatin arm and three patients in the paclitaxel/cisplatin arm). Caution should, however, be exercised when interpreting any differences because of the limited number of patients having received subsequent chemotherapy in each study arm.To assess whether patients who received subsequent treatment did benefit in terms of survival, the median survival was calculated for both treatment arms within the two subgroups of patients who received follow-up chemotherapy and patients who did not. However, because this grouping factor is affected by the efficacy itself (eg, patients who died early cannot have had follow-up chemotherapy), any comparisons are biased. Therefore, these results should be interpreted with caution. In the subgroup of patients who received follow-up chemotherapy, the median survival in the high-dose cisplatin arm (n = 76) was 12.7 months, whereas in the paclitaxel/cisplatin arm (n = 57), it was 11.6 months. In the subgroup of patients who did not receive follow-up chemotherapy, the median survival in the high-dose cisplatin arm (n = 131) was 6.7 months, whereas in the paclitaxel/cisplatin treatment arm (n = 150), it was 7.0 months.1. Gatzemeier U, von Pawel J, Gottfried M, et al: Phase III comparative study of high-dose cisplatin versus a combination of paclitaxel and cisplatin in patients with advanced non–small-cell lung cancer. J Clin Oncol 18:: 3390,2000-3399, Link, Google Scholar