Influence of previous chemotherapy on the efficacy of subsequent docetaxel therapy in advanced non-small cell lung cancer patients.
OBJECTIVE
To identify factors, particularly the previous use of paclitaxel, that might influence the efficacy of subsequent docetaxel therapy.


METHODS
The patient characteristics, responses, and survivals were compared between the two groups that had received a combination of carboplatin and paclitaxel (group P), and a combination of a platinum and an agent other than paclitaxel (group NP).


RESULTS
A total of 227 patients (127 in group P, and 100 in group NP) were recruited from a hospital-based registry. Two hundred twenty patients were evaluated for the survival, and 210 patients were evaluated for the response of docetaxel therapy. The response rate to docetaxel therapy (14.2% versus 16.0%, p = 0.702) or the median survival time (10.9 months versus 11.1 month, p = 0.567) did not differ between groups P and NP. The results of multivariate analysis, adjusted for sex, age, and performance status at the start of docetaxel therapy, showed that not the regimen per se, but the response to previous chemotherapy significantly influenced the response rate of docetaxel therapy (odds ratio [OR]: 1.38, 95% confidential interval [CI]: 0.63-3.01; and OR: 2.93, 95% CI: 1.28-6.72, respectively). As for the overall survival, neither the response to nor the previous chemotherapy regimen had any impact (hazard ration [HR]: 0.90, 95% CI 0.66-1.22; HR 0.88, 95% CI 0.65-1.20, respectively).


CONCLUSIONS
The previous use of paclitaxel had no impact on the response or survival to subsequent docetaxel therapy. In contrast, the response to previous chemotherapy had a predictive value in relation to responses to subsequent docetaxel therapy in patients with advanced non-small cell lung cancer.
Goto
Yasushi
Y
Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
Sekine
Ikuo
I
Yamada
Kazuhiko
K
Nokihara
Hiroshi
H
Yamamoto
Noboru
N
Kunitoh
Hideo
H
Ohe
Yuichiro
Y
Tamura
Tomohide
T
D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D018287:Carcinoma, Large Cell / Q000188:drug therapy / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000556:secondary; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D016879:Salvage Therapy; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage
D043823:Taxoids; D000077143:Docetaxel; D016190:Carboplatin; D017239:Paclitaxel