PACLITAXEL, CISPLATIN, ETOPOSIDE COMBINATION CHEMOTHERAPY - A MULTIFRACTIONATED BOLUS DOSE SCHEDULE FOR NONSMALL CELL LUNG-CANCER

In this phase II study, paclitaxel was added to the combination of cis platin and etoposide (TPE regimen), in 37 patients with advanced non-s mall cell lung cancer, using a multifractionated dosing schedule. The total dose of paclitaxel (175-200 mg/m(2)); cisplatin (75 mg/m(2)); an d etoposide (175-200 mg/m(2)) was divided into five daily doses admini stered over 3 h with cycles repeated at 21-28 days. 15 patients had st age III A or B disease and 22 stage TV disease. 32 patients were evalu able for toxicity and 37 for response. Neutropenia was the most promin ent toxicity. Grade 3 or grade 4 neutropenia was observed in 12 (38%) and 9 (25%) of the patients, respectively and 11 patients required hos pitalisation. 3 patients died secondary to chemotherapy related sepsis . Diarrhoea (grade 3, 3 patients; grade 4, 2 patients) was the only ot her significant non-haematological acute toxicity. The optimal dose ra te for this multifractionated regimen was paclitaxel 35 or 40 mg/m(2)/ fraction; cisplatin 15 mg/m(2)/fraction; etoposide 35 or 40 mg/m(2)/fr action. Responses were observed in 28 of 37 evaluable patients (3 comp lete response; 25 partial response [76%]. 22 patients are alive; 8 wit h stage III B disease received radiation or surgery (3 had minimal or no tumour in the pathology specimen). TPE is a highly active regimen f or non-small cell lung cancer and multifractionated dose scheduling is a feasible and well tolerated system. (C) 1998 Elsevier Science Ltd. All rights reserved.