Efficacy and safety of paclitaxel poliglumex as first-line chemotherapy in patients at high risk with advanced-stage non-small-cell lung cancer: results of a phase II study.
BACKGROUND
The objectives of this open-labeled, multicenter, phase II trial were to evaluate response, survival, and tolerability in patients at high risk (Eastern Cooperative Oncology Group performance status [PS] of 2 or age >or= 70 years) with advanced-stage non-small-cell lung cancer (NSCLC) receiving single-agent paclitaxel poliglumex as first-line monotherapy.


METHODS
Paclitaxel poliglumex was administered as a 10-20-minute infusion on day 1 of each 3-week cycle. Thirty patients were enrolled: 28 received paclitaxel poliglumex 175 mg/m2, and 2 received 235 mg/m2. Patients exhibiting a partial response (PR; by Response Evaluation Criteria in Solid Tumors) or stable disease (SD) continued uninterrupted treatment with paclitaxel poliglumex for <or= 8 cycles.


RESULTS
Neither patient treated at the 235 mg/m2 dose was evaluable for response. The overall response rate was 7% (PR in 2 patients), and 16 patients (57%) experienced SD. Of the 20 patients with stage IV disease, 2 exhibited a PR, and 13 exhibited SD. Median duration of response in patients with SD or better was 9 weeks. Overall median survival was 6 months. Median survival for patients with a PS of 0/1 or 2 was 7.8 months and 5.7 months, respectively; median survival for patients aged >or= 70 years was 7.8 months. No grade 4 nonhematologic toxicities were reported. Three patients experienced grade 3 neuropathy. Weekly hematologic assessments showed grade 3 anemia in 2 patients, grade 3 neutropenia (not associated with neutropenic fever) in 3 patients, and grade 4 neutropenia in 2 patients. No patient required growth factor support.


CONCLUSIONS
The results of this study indicate that paclitaxel poliglumex is generally well tolerated and has activity at a dose level of 175 mg/m2 as first-line monotherapy in patients at high risk with advanced NSCLC.
Richards
Donald A
DA
US Oncology, Inc., Tyler Cancer Center, Tyler, TX 75701, USA. donald.richards@usoncology.com
Richards
Paul
P
Bodkin
David
D
Neubauer
Marcus A
MA
Oldham
Fred
F
D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D018450:Disease Progression; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel