Weekly paclitaxel and paraplatin as first line chemotherapy in patients with advanced NSCLC

ABSTRACT

Optimal platinum based combination regimen for advanced NSCLC remains to be defined. Weekly Taxol and paraplatin is an effective and generally well tolerated regimen for first line treatment for stage III and IV NSCLC and affords potential for lower toxicity and increases exposure to drugs with alternative cytotoxic/cytostatic mechanisms. Thirty patients with histologically or cytologically proven NSCLC stages IIIb and IV were included during the period between March 2001-March 2003 with the following criteria, median age was 55 years, measurable or evaluable disease, PS bone marrow, liver and renal functions and no prior chemotherapy. Paclitaxel 80mg/m[2] d 1,8,15 followed by paraplatin AUC 6 d1 was administered every 4 weeks. Responses were assessed every 2 cycles, and patients showing an objective responses [CR or PR] or stable disease continued treatment for 6 cycles. Radiation therapy was given for patients with stages IIIb without progressive disease. Thirty patients were evaluable for response, median age 55 years, range [49-60], PS histology was Squamous cell carcinoma in 50%, adenocarcinoma in 40%, large cell carcinoma 6.7% and others 3.3%. Twenty patients had stage IIIb [66.7%], 10 patients stage IV [33.3%]. The median delivered chemotherapy cycles was 4. Overall response rate was 46.7% [CR 6.7%, PR 40%], stable disease 33.3%, one year survival was 53.3%. Hematologic toxicity was as follow, 2 patients with grade 3 anaemia [6.7%], 2 patients with grade 3 neutropenia without fever [6.7%] and one patient with peripheral neuropathy. Weekly Taxol and paraplatin is feasible, active, generally well tolerated regimen with relative lack of myelosuppression