1221 - Weekly paclitaxel versus the standard 3-weekly schedule in patients with non-small cell lung cancer

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anticancer agents
Non-small-cell lung cancer
Therapy
Biological therapy
Presenter Inas Abdel Halim
Authors I. Abdel Halim1, M. El-Ashry2, W. El-Sadda3, S. Temraz1
  • 1Clinical Oncology & Nuclear Medicine, Mansoura University Hospital School of Medicine, 35511 - Mansoura/EG
  • 2Clinical Oncology, Mansoura University HospitalSchool of Medicine, EG-35511 - Mansoura/EG
  • 3Clinical Oncology And Nuclear Medicine, Mansoura University Hospital School of Medicine, 35511 - Mansoura/EG

Abstract

Background

Paclitaxel is one of the active drugs in non-small cell lung cancer (NSCLC). Weekly paclitaxel seems less toxic and more effective compared to paclitaxel every three weeks (possibly because of the proapoptotic and angiogenic activity) the dose intensity is quiet higher with tolerable toxicities. The purpose of the study is to compare the efficacy of weekly paclitaxel to the every three weeks schedule in terms of response, toxicity profile, PFS and OS. Patients

Methods

Between Sep 2007 & Sep 2009, eighty patients were enrolled in the study, 40 in each group. Eligibility criteria were chemo-naiive patients, stage III & IV histologically proven NSCLC, WHO PS 0-1, adequate bone marrow, kidney & liver functions. Patients were randomized for 6-8 cycles of either weekly paclitaxel 80 mg/m2 D1,8,15 (1 hour IV infusion) and paraplatin AUC = 5 D1 (30 min IV infusion ) every 4 weeks (Group A) or paclitaxel 175 mg/m2 and paraplatin AUC = 5 every 3 weeks (Group B). Prophylactic growth factor support was allowed if indicated in Group B. Response was assessed every 2 cycles, patients who showed objective response (CR, PR, or SD) had continued to 8 cycles.

Results

All patients were evaluable for response, toxicity, and survival. The median age was 56 years (range 42-64) in both groups. Median WHO PS 1. Male to female ratio was 4:1. Stage III 60% & 62.5%, stage IV 40% & 37.5% in groups A & B respectively. The overall response rates ware 60% (CR 10%, PR 50%) & 40% (CR 5%, PR 35%) in groups A & B respectively. No grade IV toxicities were observed in either group. In group A & B; grade II anemia occurred in 15 & 25% of patients, grade III neutropenia was noted in 10 & 30% of patients, and grade II neuropathy occurred in 10 & 50% of patients in group A & B respectively. Median time to progression and median survival were 10 & 7 months and 14 & 11 months respectively.

Conclusion

Weekly paclitaxel is more effective than the every 3 weeks administration in the treatment of advanced NSCLC with higher RR, TTP, OS and better toxicity profile.

Disclosure

All authors have declared no conflicts of interest.