Annals of Oncology 14:116-122, 2003
© 2003 European Society for Medical Oncology
Original Paper |
Docetaxel as neoadjuvant therapy for radically treatable stage III non-small-cell lung cancer: a multinational randomised phase III study
1 Department of Internal Medicine, Division of Respiratory Diseases, Helsinki University Central Hospital, Helsinki, Finland; 2 Department of Radiation Oncology, Groote Schuur Hospital, Cape Town, South Africa; 3 Academic Hospital, Maastricht, The Netherlands; 4 Faculty Hospital, Prague, Czech Republic
Received 30 November 2001; revised 10 July 2002; accepted 18 July 2002
Background:
Docetaxel (Taxotere®) is a potent anticancer agent, with proven efficacy as first-line therapy in non-small-cell lung cancer (NSCLC). The aim of this large randomised multicentre phase III study was to evaluate docetaxel in the neoadjuvant (pre-operative) setting.
Patients and methods:
Patients with stage IIIA or locally treatable IIIB NSCLC were randomly assigned to receive neoadjuvant docetaxel (n = 134) or no chemotherapy (n = 140) before surgery/curative-intention radiotherapy. Patients received up to three 3-weekly cycles of docetaxel (100 mg/m2) as 1-h intravenous infusions.
Results:
Median survival was 14.8 months in the docetaxel group and 12.6 months in the control group. Median times to disease progression were 9.0 months (docetaxel arm) and 7.6 months (control arm). There were three complete responses and 25 partial responses in patients treated with docetaxel who were evaluable for response (n = 101). Docetaxel was well-tolerated: 103 patients (77%) received all three planned cycles. The major toxicity was grade 4 neutropenia (69 patients, 55%) and neutropenic fever (eight patients, 6%). Radiotherapy was well-tolerated after docetaxel administration.
Conclusions:
Neoadjuvant docetaxel is generally well-tolerated and shows a promising trend towards longer survival in patients with NSCLC.
Key words: docetaxel (Taxotere®), induction, neoadjuvant, non-small-cell lung cancer
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