Weekly docetaxel as a single agent and in combination with gemcitabine in elderly and poor performance status patients with advanced non--small cell lung cancer

Abstract

Administering docetaxel weekly at a relatively low dose minimizes myelosuppression and reduces nonhematologic toxicities. In a community-based phase II trial conducted in 39 elderly or poor performance status patients with advanced non--small cell lung cancer, weekly 36 mg/m(2) docetaxel produced a response rate of 20%. The response rate was 26% in patients with an Eastern Cooperative Oncology Group performance status of 0 or 1. Actual 1-year survival was 28% and actuarial 2-year survival was 15%. These results are similar to those achieved with other active single agents. The regimen of weekly docetaxel used was associated with minimal hematologic toxicity. There were no cases of grade 4 leukopenia, febrile neutropenia, toxicity-related hospital admissions, or treatment-related death. Nonhematologic toxicities were also mild, even in performance status 2 patients. In a subsequent phase II trial, a similar group of patients received weekly docetaxel at 30 mg/m(2) plus weekly gemcitabine 800 mg/m(2), both drugs given on days 1, 8, and 15 every 28 days. Preliminary analysis of data for the first 41 patients enrolled show an objective response rate of 29%, with an additional 45% of patients having stable disease. Although 26% of patients missed the day 15 dose of gemcitabine and docetaxel because of myelosuppression, the combination regimen was generally well tolerated. There were no hospitalizations caused by complications of myelosuppression. One patient developed bilateral pulmonary infiltrates, possibly treatment-related, and died of respiratory failure. Further evaluation of weekly docetaxel-based combinations is indicated. Semin Oncol 28 (suppl 9):21-25.