NEW ORLEANS—In patients with brain metastases related to non-small-cell lung cancer, adding paclitaxel(Drug information on paclitaxel) (Taxol) plus carboplatin(Drug information on carboplatin) (Paraplatin) to standard radiotherapy may increase overall treatment efficacy, French investigators reported at the 36th Annual Meeting of the American Society of Clinical Oncology.
The rationale for the combined treatment is based on the use of radiotherapy as standard treatment of brain metasta-ses—although it increases survival by less than 6 months—and recent data suggesting that chemotherapy may also be effective in this setting.
This phase II multicenter study evaluated chemotherapy followed by radiotherapy in 46 chemonaïve patients with inoperable brain metastases. Patients received paclitaxel 200 mg/m² over 3 hours and carboplatin AUC 6 on day 1 every 3 weeks. Radiotherapy 30 Gy in 10 fractions to the brain was delivered to patients who did not respond after two to four courses of chemotherapy.
Two Courses Effective
Two courses of this regimen were considered effective and of low toxicity, reported Gilles Robinet, MD, of the Hôpital Augustin Morvan, Brest, France. The median number of cycles per patient was 2.5, for a total of 144 during the study.
After two cycles of chemotherapy, the effect on brain metastases included partial response in 8 patients (18%), stable disease in 15 (36%), and progressive disease in 19 (42%) (responses were undetermined in 2 patients).
The effects on extrabrain metastases included partial responses in 10 (22%), stable disease in 21 (47%), and progressive disease in 9 (20%) (responses were undetermined in 5 patients).
