***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To confirm the promising phase II results of docetaxel monotherapy , this phase III trial was conducted of chemotherapy for patients with advanced non-small-cell lung cancer ( NSCLC ) who had previously failed platinum-containing chemotherapy . PATIENTS AND METHODS A total of 373 patients were r and omized to receive either docetaxel 100 mg/m(2 ) ( D100 ) or 75 mg/m(2 ) ( D75 ) versus a control regimen of vinorelbine or ifosfamide ( V/I ) . The three treatment groups were well-balanced for key patient characteristics . RESULTS Overall response rates were 10.8 % with D100 and 6.7 % with D75 , each significantly higher than the 0.8 % response with V/I ( P = .001 and P = .036 , respectively ) . Patients who received docetaxel had a longer time to progression ( P = .046 , by log-rank test ) and a greater progression-free survival at 26 weeks ( P = .005 , by chi(2 ) test ) . Although overall survival was not significantly different between the three groups , the 1-year survival was significantly greater with D75 than with the control treatment ( 32 % v 19 % ; P = .025 , by chi(2 ) test ) . Prior exposure to paclitaxel did not decrease the likelihood of response to docetaxel , nor did it impact survival . There was a trend toward greater efficacy in patients whose disease was platinum-resistant rather than platinum-refractory and in patients with performance status of 0 or 1 versus 2 . Toxicity was greatest with D100 , but the D75 arm was well-tolerated . CONCLUSION This first r and omized trial in this setting demonstrates that D75 every 3 weeks can offer clinical ly meaningful benefit to patients with advanced NSCLC whose disease has relapsed or progressed after platinum-based chemotherapy PURPOSE To evaluate whether treatment with single-agent docetaxel would result in longer survival than would best supportive care in patients with non-small-cell lung cancer who had previously been treated with platinum-based chemotherapy .  Secondary end points included assessment of response ( docetaxel arm only ) , toxicity , and quality of life . PATIENTS AND METHODS Patients with performance statuses of 0 to 2 and stage IIIB/IV non-small-cell lung cancer with either measurable or evaluable lesions were eligible for entry onto the study if they had undergone one or more platinum-based chemotherapy regimens and if they had adequate hematology and biochemistry parameters . They were excluded if they had symptomatic brain metastases or if they had previously been treated with paclitaxel .  Patients were stratified by performance status and best response to cisplatin chemotherapy and were then r and omized to treatment with docetaxel 100 mg/m(2 ) ( 49 patients ) or 75 mg/m(2 ) ( 55 patients ) or best supportive care . Patients in both arms were assessed every 3 weeks . RESULTS One hundred four patients ( 103 of whom were eligible for entry onto the study ) were well balanced for prognostic factors . Of 84 patients with measurable lesions , six ( 7 . 1 % ) achieved partial responses ( three patients at each dose level ) . Time to progression was longer for docetaxel patients than for best supportive care patients ( 10.6 v 6.7 weeks , respectively ; P < .001 ) , as was median survival ( 7.0 v 4.6 months ; log-rank test , P = .047 ) . The difference was more significant for docetaxel 75 mg/m(2 ) patients , compared with corresponding best supportive care patients ( 7.5 v 4.6 months ; log-rank test , P = .010 ; 1-year survival , 37 % v 11 % ; chi(2 ) test , P = .003 ) . Febrile neutropenia occurred in 11 patients treated with docetaxel 100 mg/m(2 ) , three of whom died , and in one patient treated with docetaxel 75 mg/m(2 ) . Grade 3 or 4 nonhematologic toxicity , with the exception of diarrhea , occurred at a similar rate in both the docetaxel and best supportive care groups . CONCLUSION Treatment with docetaxel is associated with significant prolongation of survival , and at a dose of 75 mg/m(2 ) , the benefits of docetaxel therapy outweigh the risks BACKGROUND The NCIC Clinical Trials Group conducted the BR.21 trial , a r and omized placebo-controlled trial of erlotinib ( an epidermal growth factor receptor tyrosine kinase inhibitor ) in patients with previously treated advanced non-small cell lung cancer . This trial accrued patients between August 14 , 2001 , and January 31 , 2003 , and found that overall survival and quality of life were improved in the erlotinib arm than in the placebo arm . However , funding restrictions limit access to erlotinib in many countries . We undertook an economic analysis of erlotinib treatment in this trial and explored different molecular and clinical predictors of outcome to determine the cost-effectiveness of treating various population s with erlotinib . METHODS Re source utilization was determined from individual patient data in the BR.21 trial data base . The trial recruited 731 patients ( 488 in the erlotinib arm and 243 in the placebo arm ) .  Costs arising from  erlotinib treatment , diagnostic tests , outpatient visits , acute hospitalization , adverse events , lung cancer-related concomitant medications , transfusions , and radiation therapy were captured . The incremental cost-effectiveness ratio was calculated as the ratio of incremental cost ( in 2007 Canadian dollars ) to incremental effectiveness ( life-years gained ) . In exploratory analyses , we evaluated the benefits of treatment in selected subgroups to determine the impact on the incremental cost-effectiveness ratio . RESULTS The incremental cost-effectiveness ratio for erlotinib treatment in the BR.21 trial population was $ 94,638 per life-year gained ( 95 % confidence interval = $ 52,359 to $ 429,148 ) . The major drivers of cost-effectiveness included the magnitude of survival benefit and erlotinib cost . Subgroup analyses revealed that erlotinib may be more cost-effective in never-smokers or patients with high EGFR gene copy number . CONCLUSION With an incremental cost-effectiveness ratio of $ 94 638 per life-year gained , erlotinib treatment for patients with previously treated advanced non-small cell lung cancer is marginally cost-effective . The use of molecular predictors of benefit for targeted agents may help identify more or less cost-effective subgroups for treatment BACKGROUND Docetaxel in combination with cisplatin or gemcitabine are active chemotherapy reigimes against non-small-cell lung cancer . We compared the efficacy and safety of a combination of cisplatin and docetaxel ( group 1 ) with that of gemcitabine and docetaxel ( group 2 ) in the treatment of advanced non-small-cell lung cancer in a prospect i ve , r and omised , multicentre trial . METHODS Patients with stage IIIB or IV lung cancer who had not had prior chemotherapy were allocated either to group 1 and treated with docetaxel ( 100 mg/m(2 ) , day 1 ) and cisplatin ( 80 mg/m(2 ) , day 2 ) or to group 2 and treated with gemcitabine ( 1100 mg/m(2 ) , days 1 and 8) and docetaxel ( 100 mg/m(2 ) , day 8) . All patients received recombinant human granulocyte colony-stimulating factor ( 150 mg/m(2 ) ) . All patients received recombinant human granulocyte colony-stimulating factor ( 150 mg/m(2 ) ) had appropriate st and ard premedication . Response and toxicity were assessed using WHO criteria . Analysis was by intention to treat . FINDINGS 441 patients were r and omly assigned to receive docetaxel/cisplatin ( group 1 , n=219 ) or gemcitabine/docetaxel ( group 2 , n=222 ) . 14 patients in group 1 and 21 patients in group 2 were not evaluable . Objective response rates were similar in the two groups : group 1 , 32.4 % ( 95 % CI 26.2 - 38.6 % ; 1.4 % complete response and 31 % partial response ) ; group 2 , 30.2 % ( 24.5 - 36.2 % ; 0.9 % complete response and 29.3 % partial response ) . The two groups did not differ in median duration of response , time to tumour progression , overall survival , or 1 year or 2 year survival rates . INTERPRETATION Both drug combinations had comparable activity in patients with advanced cancer who had not previously had chemotherapy ; however , gemcitabine and docetaxel had the most favourable toxicity profile BACKGROUND We conducted a r and omized study to determine whether any of three chemotherapy regimens was superior to cisplatin and paclitaxel in patients with advanced non-small-cell lung cancer . METHODS A total of 1207 patients with advanced non-small-cell lung cancer were r and omly assigned to a reference regimen of cisplatin and paclitaxel or to one of three experimental regimens : cisplatin and gemcitabine , cisplatin and docetaxel , or carboplatin and paclitaxel . RESULTS The response rate for all 1155 eligible patients was 19 percent , with a median survival of 7.9 months ( 95 percent confidence interval , 7.3 to 8.5 ) , a 1-year survival rate of 33 percent ( 95 percent confidence interval , 30 to 36 percent ) , and a 2-year survival rate of 11 percent ( 95 percent confidence interval , 8 to 12 percent ) . The response rate and survival did not differ significantly between patients assigned to receive cisplatin and paclitaxel and those assigned to receive any of the three experimental regimens . Treatment with cisplatin and gemcitabine was associated with a significantly longer time to the progression of disease than was treatment with cisplatin and paclitaxel but was more likely to cause grade 3 , 4 , or 5 renal toxicity ( in 9 percent of patients , vs. 3 percent of those treated with cisplatin plus paclitaxel ) . Patients with a performance status of 2 had a significantly lower rate of survival than did those with a performance status of 0 or 1 . CONCLUSIONS None of four chemotherapy regimens offered a significant advantage over the others in the treatment of advanced non-small-cell lung cancer Abstract Background : During the 1990s , a number of new cytotoxic agents with clinical ly relevant activity in non-small-cell lung cancer ( NSCLC ) , and with a more favourable therapeutic index than drugs already in use , became available . Given the high prices of these new drugs and the large number of patients affected , it is important to compare the relative benefits and costs of these treatments with the existing regimens before treatment policy decisions are changed . Purpose : An economic evaluation of three different regimens of chemotherapy in patients with advanced NSCLC was performed from the perspective of the Dutch health insurance system using tariffs valid for 2002 . The economic evaluation was integrated into a phase III clinical trial in which the reference regimen cisplatinpaclitaxel was compared with two experimental regimens : cisplatin-gemcitabine and gemcitabine-paclitaxel . Material s and methods : Unit costs were applied to re source use data collected prospect ively on case report forms during the trial . The average total ( uncensored ) cost per patient was determined for each of the treatment groups . The principal outcome measure for the economic evaluation was the estimated mean survival time per treatment group . This outcome was then incorporated into incremental cost-effectiveness ratios based on costs corrected for censoring . The impact of uncertainty was assessed by bootstrap techniques , and the analysis and interpretation of the data focused on the bivariate density of differences in outcomes and costs in the incremental cost-effectiveness plane . The final results were summarised by the derivation of cost-effectiveness acceptability curves . Results : The estimated mean survival time was equivalent in the two cisplatinbased regimens with largely overlapping confidence intervals . There was a 99 % probability that cisplatin-gemcitabine is the least costly regimen of the two and a 72 % probability that this regimen reduces costs while at the same time improving survival . Compared with cisplatin-paclitaxel , the gemcitabine-paclitaxel regimen engendered a borderline significant reduction in mean survival time combined with an almost 90 % probability of an increase in costs . Conclusion : The two cisplatin-based regimens are equivalent in terms of survival , but cisplatin-gemcitabine may reduce costs by approximately € 2000 per patient compared with cisplatin-paclitaxel . Gemcitabine-paclitaxel is a dominated option with higher costs and a reduction in mean survival time compared with cisplatinpaclitaxel Introduction : To estimate the cost-effectiveness of first-line cisplatin/pemetrexed ( Cis/Pem ) compared with cisplatin/gemcitabine ( Cis/Gem ) , carboplatin/paclitaxel ( Carb/Pac ) , and carboplatin/paclitaxel/bevacizumab ( Carb/Pac/Bev ) in patients with advanced non-small cell lung cancer ( NSCLC ) , particularly in those with nonsquamous cell histology ( i.e. , adenocarcinoma , 
    Output:
    
In second-line treatment , docetaxel was cost effective compared with best supportive care ; erlotinib was cost effective compared with placebo ; and docetaxel and pemetrexed were dominated by erlotinib .
We found indications of superiority in terms of cost effectiveness for gemcitabine+cisplatin in a first-line setting , and for erlotinib in a second-line setting