© 2005 European Society for Medical Oncology
Original article |
Phase II randomised trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC)
1 Centre Régional de Lutte Contre le Cancer Baclesse, Caen; 2 Hôpital Hautepierre, Strasbourg; 3 Centre Hospitalier Général, Belfort; 4 Centre Hospitalier Général Maillot, Briey; 5 Hôpital Saint Antoine, Paris XII; 6 Hôpital d'Instruction des Armées de Percy, Clamart; 7 Centre Hospitalier Paul Morel, Vesoul; 8 CHU-Hôpital A. de Villeneuve, Montpellier; 9 Hôpital St Louis, Paris; 10 Laboratoire Aventis, Paris; 11 Hôpital Lyautey, Strasbourg Cedex, France
Correspondence to: Dr E. Quoix, Hôpital Lyautey, 1, Place de l'hôpital, 67091 Strasbourg Cedex, France. Tel: +33-3-88-11-63-02; Fax: +33-3-88-11-63-35; Email: elisabeth.quoix{at}chru-strasbourg.fr
Background: Taxotere® (docetaxel) at the dose of 75 mg/m2 every 3 weeks is a standard therapy for pretreated non-small-cell lung cancer (NSCLC). The aim of this study was to evaluate the safety profile of two schedules of docetaxel administration (every 3 weeks versus weekly) in patients with pretreated NSCLC.
Patients and methods: From February 2000 to February 2001, 125 patients with locally advanced or metastatic NSCLC were randomised after failure of a previous platinum-based regimen to receive either docetaxel 75 mg/m2 administered every 3 weeks (Dq3w) or docetaxel 40 mg/m2 given weekly for 6 weeks followed by 2 weeks of rest (Dqw). Safety evaluations focused on grade 3–4 neutropenia, febrile neutropenia, nausea-vomiting and asthenia.
Results: Patients' characteristics were well balanced between arms. The most common National Cancer Institute Common Toxicity Criteria (NCI-CTC) grade 3–4 toxicity was neutropenia, which occurred in 48.4% of Dq3w patients versus 15.9% of Dqw patients (P=0.001). In addition, febrile neutropenia were observed in 6.5% of patients in Dq3w versus 0% in Dqw. Grade 3–4 asthenia was more frequent in Dqw. Other non-haematological toxicities were very rare. Regarding efficacy, there was a trend towards a better disease control rate in Dq3w: 32.2% versus 25.4% in Dqw. Median time to progression and survival were rather similar in both arms, respectively: 2.1 months (range 2–3.2) and 5.8 months (range 4.0–7.0) in Dq3w and 1.8 months (range 1.6–2.3) and 5.5 months (range 3.7–6.6) in Dqw.
Conclusions: While both schedules had a favourable safety profile, a significant lower rate of severe neutropenia was observed in the weekly arm. Both regimens had similar efficacy. The weekly regimen could be considered as a good alternative for patients at risk of severe neutropenia.
Key words: chemotherapy, docetaxel, non-small-cell lung cancer, second-line
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