Second-Line Chemotherapy with Docetaxel for NSCLC Well-Tolerated and Effective
A recent article in the Annals of Oncology reports that weekly chemotherapy with docetaxel is a well-tolerated and effective treatment for patients diagnosed with non-small cell lung cancer (NSCLC).
Lung cancer is the leading cause of cancer-related deaths in the United States and Europe. NSCLC is the most common type of lung cancer and is a malignancy that arises from the tissues of the lung. Under most circumstances, NSCLC is not curable. Current treatments include surgery, chemotherapy and radiation in an attempt to destroy cancer cells or prevent further tumor growth. Chemotherapy with platinum-based chemotherapy is frequently used to treat NSCLC initially; however, second-line treatment options may vary depending on the patient’s overall condition.
In this recent trial, 125 patients diagnosed with locally advanced or metastatic NSCLC who had failed previous treatment with platinum-based chemotherapy were randomized to receive either docetaxel 75mg/m2 every 3 weeks or docetaxel 40mg/m2 weekly for 6 weeks followed by a 2-week period of rest. Patients were then evaluated for a drop in blood counts, nausea and vomiting, and malaise.
Results of the study found that the most common side effects among both groups was a drop in the white blood cell count (neutropenia), which affected 48.4% of patients receiving treatment every 3 weeks and 15.9% of the patients who received weekly chemotherapy. In addition, in the group who received treatment every 3 weeks, 6% experienced a fever in addition to neutropenia, which indicates the possibility of infection. Although other side effects were minimal, generalized malaise was more frequent among the patients receiving treatment each week when compared to those who received treatment every 3 weeks.
In regards to efficacy, there appeared to be a trend of slightly better disease control in the group treated with the larger dose every 3 weeks, 32% vs. 25%. The average time to progression and survival rates were similar; in the group treated weekly, the time to progression was 1.8 months and 5.5 months for overall survival, compared to 2.1 months and 5.8 months in the group treated every 3 weeks.
Researchers concluded that both schedules were well-tolerated overall and effective in the second-line treatment of NSCLC; however, the weekly regimen may be a more appropriate option for patients at risk for neutropenia. Patients are encouraged to speak to their physician regarding treatment options for their specific situation.
Reference: Gervais R, Ducolone A, Breton J, et al. Phase II Randomized Trial Comparing Docetaxel Given Every 3 Weeks With Weekly Schedule as Second Line Therapy in Patients With Advanced Non-Small Cell Lung Cancer. Annals of Oncology. 2005; 16: 90-96.
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