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Persons with non-small cell lung cancer that has spread from the lung to other parts of the body often receive chemotherapy with a platinum-containing compound (cisplatin or carboplatin) to alleviate the symptoms of disease and prolong survival time. However, effective new treatments are still needed for persons whose disease no longer responds to this initial therapy. According to 1 newly published study, the use of a drug called docetaxel may be effective against non-small cell lung cancer that has been previously treated with platinum therapy, affording a prolonged survival time for persons with this type of disease.

Non-small cell lung cancer (NSCLC) is a term used to describe several types of lung cancer, including epidermoid or squamous carcinoma, adenocarcinoma, large cell carcinoma, adenosquamous carcinoma, and undifferentiated carcinoma. Treatment options for NSCLC may include surgery, radiation therapy, and/or chemotherapy, depending on the

stage of the cancer (extent of disease at diagnosis).

Stage IIIB NSCLC is cancer that began in the lung and then spread to the chest wall, diaphragm, and/or lymph nodes in the chest or neck.

Stage IV NSCLC is cancer that originated in the lung and then spread to other parts of the body (called

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advanced or

metastatic disease). Several chemotherapy combinations may be used to treat persons with this type of disease, with the most effective regimens being those that contain a platinum compound. However, when the disease stops responding to the platinum therapy, other treatments are needed to relieve the symptoms of disease and prolong survival time. A class of drugs called the taxanes, including docetaxel and paclitaxel, has produced response rates up to 23% in persons with NSCLC for which platinum therapy has stopped working. However, the full impact of the taxanes on the treatment of metastatic NSCLC is not yet known.

Canadian researchers treated 104 persons with recurrent NSCLC for whom initial platinum-based chemotherapy had failed. The researchers assigned the patients to receive either docetaxel or the best supportive care available (care to relieve pain and other symptoms and complications of disease). Seven percent of the patients had a response to the treatment with docetaxel. The average survival time was 7 months in those receiving the docetaxel, compared with 4.6 months in those receiving supportive care only. The survival rates after 1 year were 37% in those receiving docetaxel and 11% in those receiving supportive care only.

From these findings, the researchers concluded that docetaxel provides anti-cancer activity against NSCLC after treatment with platinum and affords a prolonged survival time over the use of supportive care alone. Future studies will combine other anti-cancer drugs with docetaxel in an effort to further improve the effectiveness of treatment for persons with this disease. Individuals who have metastatic NSCLC that is no longer responding to cisplatin or carboplatin may wish to talk with their doctor about the risks and benefits of participating in a clinical trial in which docetaxel or other promising new treatments are being studied. Two sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute ( and the Clinical Trials section and service offered by Cancer (

(Journal of Clinical Oncology, Vol 18, No 10, pp 2095-2103, 2000)

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