PITTSBURGH, July 31 – According to findings published in the Aug. 1 issue of the Journal of Clinical Oncology, weekly regimens of paclitaxel in combination with full doses of carboplatin is reasonably well tolerated and the efficacy results appear promising. The study, led by Chandra P. Belani, M.D., professor of medicine, University of Pittsburgh and co-director, Lung Cancer Program, University of Pittsburgh Cancer Institute (UPCI), compared three regimens of weekly paclitaxel plus carboplatin in patients with advanced non-small cell lung cancer (NSCLC) and found that higher weekly doses of paclitaxel in combination therapy for lung cancer did not result in an added benefit for patients and caused a higher incidence of adverse side effects.
"Our study demonstrates that both agents can be administered with ease and without substantial toxicity when weekly paclitaxel is combined with full doses of carboplatin administered on day one of each cycle with few side effects," said Dr. Belani. "Administration of a higher weekly dose of paclitaxel did not improve survival and was more likely to cause toxic effects from treatment. This is a major concern for lung cancer patients with advanced disease given that the primary goal of therapy is to improve survival, reduce symptoms and to improve the patient's quality of life."
The purpose of the study was to explore the efficacy and safety of three regimens of weekly paclitaxel plus carboplatin. The study included 401 patients with stage III and IV NSCLC from 47 community and academic sites in the United States. Patients were randomly assigned into one of three groups. The first group received 100mg/m2 of paclitaxel weekly for three of four weeks with carboplatin on day one. The second group received 100mg/m2 of paciltaxel and carboplatin weekly for three of four weeks. The third and final group received 150mg/m2 to 100mg/m2 of paclitaxel and carboplatin weekly for six of eight weeks.
Results indicated that group one was associated with overall improved efficacy and the most favorable toxicity profile. Patients assigned to this group demonstrated a response rate of 32 percent and a median survival time of 49 weeks, with a one-year survival rate of 47 percent, while patients in group two had a response rate of 24 percent and a median survival time of 31 weeks. Patients in group three had a response rate of 18 percent and a median survival time of 40 weeks.
"These results are encouraging," said Dr. Belani and will lead to increasing use of this regimen in advanced NSCLC. According to Dr. Belani, a phase III randomized study is underway to compare this schedule with the standard three week regimen of paclitaxel and carboplatin.
Lung cancer will be newly diagnosed in over 170,000 people in the United States in 2003. Non-small cell lung cancer is the most common type of lung cancer, accounting for nearly 80 percent of lung cancers.
For more information on lung cancer, please visit www.upmccancercenters.com.
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Journal
Journal of Clinical Oncology