Weekly paclitaxel/ docetaxel combined with a platinum in the treatment of advanced non-small cell lung cancer: a study on efficacy, safety and pre-medication.
OBJECTIVE
To evaluate the efficacy and safety of a weekly taxane schedule in the treatment of advanced non small cell lung cancers (NSCLCs) and to generate an optimal pre-medication protocol for weekly taxane.


METHODS
From December 2001 to June 2006, 78 patients with advanced NSCLCs were recruited from the Department of Chemotherapy, Jiangsu Cancer Hospital and Research Institute. Paclitaxel was delivered at 80-100mg/m2 on days 1 and 8 (11 cases), or 50-80 mg/m2 on days 1, 8 and 15 (23 cases), while docetaxel was given with the same schedules at 35-45 mg/m2 (30cases), or 25-35 mg/m2 (14 cases). In all cases this was combined with a platinum-based drug (cisplatin, oxaliplatin or carboplatin) , followed by a 1 week rest. Four pre-medications were attempted were also compared.


RESULTS
All 78 patients received a total of 202 courses of treatment. Dose limiting toxicity was myelosuppression. Grades 3 and 4 leukopenia occurred in 19.2% (15/78). Of the 56 eligible patients who completed at least 2 courses, none had a complete response, 20 achieved a partial response and 5 showed progression. Toxicity of pre-medications was indicated by: hypersensitivity (1 case), hypopotassemia (8 cases), myasthenia (5 cases), hiccups (1 case) and infection (2 cases). No treatment related deaths occurred.


CONCLUSIONS
Weekly administration of paclitaxel /docetaxel is a safe and active protocol for advanced NSCLCs. Our recommendations for weekly pre-medication with taxane are: dexamethasone 2.25mg-7.5mg orally 12h and 2h before, promethazine and cimetidine 30 min before paclitaxel; oral dexamethasone 4.5mg-7.5mg twice daily for three consecutive days (the day before, the day of, and the day after docetaxel), promethazine and cimetidine 30 min before docetaxel.
Zhou
Jian-Nong
JN
Department of General Surgery and Chemotherapy, Jiangsu Cancer Hospital and Research Institute, Nanjing, Jiangsu Province, China. zhoujiannong09@yahoo.com.cn
Huang
Xin-En
XE
Ye
Zhuo
Z
Li
Chao
C
Zhang
Qian
Q
Lin
Yong
Y
Jiang
Wei
W
Sunh
Wei-Li
WL
Shi
Mei-Qi
MQ
Shu
Yong-Qian
YQ
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D017239:Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D011292:Premedication / Q000379:methods; D043823:Taxoids / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D009944:Organoplatinum Compounds; D043823:Taxoids; D000077150:Oxaliplatin; D000077143:Docetaxel; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin