Phase II study of cisplatin combined to irinotecan administered alternatingly with docetaxel in advanced non-small cell lung cancer.

OBJECTIVE: To assess the activity and toxicity of cisplatin and irinotecan alternating with docetaxel in patients with advanced non-small cell lung cancer (NSCLC). MATERIAL AND METHOD: Eligibility included chemo-naïve stage IIIB with malignant effusion and stage IV NSCLC patients with measurable disease and a good performance status. Twenty-four patients were enrolled into the present study. There were 19 males and 5 females with a median age of 58.5 years and the median performance status was 1. Ninety-six percent had stage IV disease. These patients received cisplatin at 80 mg/ m2 and irinotecan at 200 mg/m2 on day 1, followed by docetaxel at 75 mg/m2 on day 22, in 6-week cycle for a maximum of 3 cycles. RESULTS: Eight out of twenty-two evaluable patients obtained a partial response (36%). The median time to tumor progression was 6 months. The median survival time and 1-year survival rate were 10.4 months and 45% respectively. The most frequent severe toxicities were neutropenia, anemia, and diarrhea. Febrile neutropenia occurred in four patients (16%), and was the cause of treatment-related deaths in two (8%). Other nonhematologic toxicities were mild including nausea, vomiting, and skin rash. CONCLUSION: Alternating cisplatin and irinotecan with docetaxel, as used in the present study was feasible and demonstrated encouraging efficacy in patients with non-small cell lung cancer However, this approach appears to be more toxic, especially in myelosuppression, than in previous reports of the sequential use of the similar agents.

Treatment of advanced non-small cell lung cancer with vinorelbine in elderly Thai patients.

The present study evaluated the efficacy and toxicity of vinorelbine as single chemotherapy for elderly Thai patients with advanced non-small cell lung cancer (NSCLC). Twenty-eight patients with no prior chemotherapy and ECOG performance status of 0-2 were enrolled in the study. There were 20 males and 8 females with a median age of 72 years, and the median ECOG performance status was 1. Eight cases were stage IIIB and 20 cases were stage IV. Fourteen cases were adenocarcinoma, 13 were squamous cell and one was large cell NSCLC. These patients received vinorelbine 25 mg/m2 on day 1 and 8. This treatment produced partial response in 5 of 25 evaluable patients (20%). Median survival time was 40 weeks. Hematologic toxicity caused 9% grade 3 anemia, 1.5% grade 4 neutropenia and 0.5% grade 4 neutropenia. Conclusion: Chemotherapy is a valuable treatment option for elderly patients with advanced NSCLC. Single agent vinorelbine is able to induce an overall response with a low toxicity level in elderly Thai patients with advanced NSCLC.