Perspectives and opportunities: Docetaxel in the current and future treatment of non-small cell lung cancer.
Docetaxel is active as monotherapy in patients with advanced or metastatic non-small cell lung cancer. In addition to the conventional 3-weekly regimen, docetaxel delivered in smaller, weekly doses to patients who are elderly or have comorbidities maintains activity while minimizing myelosuppression. Randomized phase III trials show that docetaxel monotherapy improves survival when compared with best supportive care in both first- and second-line settings. More recently, the combination of docetaxel with cisplatin in chemotherapy-naive patients has been shown to be significantly superior to the vinorelbine/cisplatin combination in terms of both increased survival and reduced toxicity. Docetaxel can be combined with nonplatinum agents such as gemcitabine to produce regimens that have substantial activity and a favorable therapeutic index. In multimodality therapy, following platinum/etoposide chemoradiation with docetaxel may have played an important role in the encouraging outcome of the recent Southwest Oncology Group 9504 study. If this can be confirmed, docetaxel appears suitable for inclusion in a range of sequential chemoradiotherapy approaches. Docetaxel can safely be combined with a platinum in patients receiving thoracic radiotherapy; and the combination is a candidate for induction therapy in patients with stage IB-IIIA disease. There is also considerable promise in combining docetaxel with any of the large number of molecularly targeted therapies now becoming available.
Green
Mark R
MR
Department of Medicine, Medical University of South Carolina, Charleston 29425, USA.
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D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D000077146:Irinotecan; D017239:Paclitaxel; D002945:Cisplatin; D002166:Camptothecin; D000093542:Gemcitabine