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

Objectives: To evaluate the efficacy and safety of a weekly taxane schedule in the treatment of advanced nonsmall cell lung cancers (NSCLCs) and to generate anoptimal pre-medication protocol for weekly taxane.
Methods:From December 2001 to June 2006, 78 patients with advanced NSCLCs were recruited from the Department ofChemotherapy, Jiangsu Cancer Hospital and Research Institute. Paclitaxel was delivered at 80-100mg/m2 ondays 1 and 8 (11cases), or 50-80mg/m2 on days 1, 8 and 15 (23cases), while docetaxel was given with the sameschedules at 35-45 mg/m2 (30cases), or 25-35mg/m2 (14cases). In all cases this was combined with a platinumbaseddrug (cisplatin, oxaliplatin or carboplatin) , followed by a 1 week rest. Four pre-medications were attemptedwere also compared.
Results: All 78 patients received a total of 202 courses of treatment. Dose limiting toxicitywas myelosuppression. Grades 3 and 4 leukopenia occurred in 19.2% (15/78). Of the 56 eligible patients whocompleted at least 2 courses, none had a complete response, 20 achieved a partial response and 5showedprogression. Toxicity of pre-medications was indicated by: hypersensitivity (1 case), hypopotassemia (8cases), 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 12hand 2h before, promethazine and cimetidine 30min before paclitaxel; oral dexamethasone 4.5mg-7.5mg twicedaily for three consecutive days (the day before, the day of, and the day after docetaxel), promethazine andcimetidine 30min before docetaxel.