Weekly dosing of the chemotherapy agent docetaxel (Taxotere) is
active and well tolerated in elderly patients with advanced
nonsmall-cell lung cancer (NSCLC), according to the results of
a phase II study published in a recent issue of Cancer
Of 38 evaluable patients, 6 had a partial response to treatment, and
1 had a complete response. Stable disease or a minor response was
noted in 13 (34%) patients at their first evaluation. Median survival
was 5 months, with a 1-year actuarial survival rate of 27%.
Based on our results, we believe that administration of
docetaxel on a weekly basis is an attractive treatment option for
elderly patients, who are frequently poor candidates for either
combination regimens or full-dose docetaxel administered every 3
weeks, said John D. Hainsworth, md, Director of Clinical
Research, at the Sarah Cannon Cancer Center in Nashville and the
studys principal investigator. These results confirm
earlier studies that found docetaxel administered weekly reduces
certain side effects, like myelosuppresion, when compared to
administration every 3 weeks.
The trial enrolled 39 men and women with advanced, untreated NSCLC
who were at least 65 years old. Younger patients were eligible only
if they were considered to be poor candidates for combination
chemotherapy regimens because of coexistent medical illness and/or
poor performance status.
The median age of the study population was 71 years. The majority of
patients had an Eastern Cooperative Oncology Group (ECOG) performance
status of 1 or 2 (54% and 41%, respectively); 27 patients had distant
metastases, and 12 had disease localized to the chest.
All study participants received weekly docetaxel, 36 mg/m²,
intravenously over 1 hour, for 6 consecutive weeks, followed by 2
weeks without treatment. After 8 weeks of treatment, patients were
reevaluated for response. All patients with either an objective tumor
response or stable disease continued to receive weekly docetaxel
according to the same treatment schedule for a maximum of 32 weeks or
until disease progression
In general, weekly docetaxel was well tolerated. Only three (8%)
patients developed severe leukopenia, and no patient developed
infection or bleeding problems as a result of myelosuppression.
Severe nonhematologic treatment-related toxicity also was uncommon.
Four (10%) patients reported fatigue or asthenia.