Novel Treatment Option in Older Patients With Relapsed Lung Cancer: Weekly Docetaxel

Weekly dosing of the chemotherapy agent docetaxel (Taxotere) is active and well tolerated in elderly patients with advanced non–small-cell lung cancer (NSCLC), according to the results of a phase II study published in a recent issue of Cancer (89[2]:328-333, 2000).

Of 38 evaluable patients, 6 had a partial response to treatment, and 1 had a complete response. Stable disease or a minor response was noted in 13 (34%) patients at their first evaluation. Median survival was 5 months, with a 1-year actuarial survival rate of 27%.

 “Based on our results, we believe that administration of docetaxel on a weekly basis is an attractive treatment option for elderly patients, who are frequently poor candidates for either combination regimens or full-dose docetaxel administered every 3 weeks,” said John D. Hainsworth, md, Director of Clinical Research, at the Sarah Cannon Cancer Center in Nashville and the study’s principal investigator. “These results confirm earlier studies that found docetaxel administered weekly reduces certain side effects, like myelosuppresion, when compared to administration every 3 weeks.”

Eligible Participants

The trial enrolled 39 men and women with advanced, untreated NSCLC who were at least 65 years old. Younger patients were eligible only if they were considered to be poor candidates for combination chemotherapy regimens because of coexistent medical illness and/or poor performance status.

The median age of the study population was 71 years. The majority of patients had an Eastern Cooperative Oncology Group (ECOG) performance status of 1 or 2 (54% and 41%, respectively); 27 patients had distant metastases, and 12 had disease localized to the chest.

Dosing Schedule

All study participants received weekly docetaxel, 36 mg/m², intravenously over 1 hour, for 6 consecutive weeks, followed by 2 weeks without treatment. After 8 weeks of treatment, patients were reevaluated for response. All patients with either an objective tumor response or stable disease continued to receive weekly docetaxel according to the same treatment schedule for a maximum of 32 weeks or until disease progression

In general, weekly docetaxel was well tolerated. Only three (8%) patients developed severe leukopenia, and no patient developed infection or bleeding problems as a result of myelosuppression.

Severe nonhematologic treatment-related toxicity also was uncommon. Four (10%) patients reported fatigue or asthenia.