Single agent docetaxel plus granulocyte-colony stimulating factor (G-CSF) in previously treated patients with advanced non small cell lung cancer. A phase II study and review of the literature

The use of salvage chemotherapy in advanced non small cell lung cancer (NSC LC) is controversial. However, many patients need to be treated in order to achieve relief of their symptoms. Docetaxel (taxotere) is one of the most active drugs for the treatment of advanced NSCLC and several studies have a lso shown its effectiveness in pretreated patients. In the present study, 2 3 patients were treated in order to evaluate both the effectiveness and tox icity of the single agent docetaxel. Furthermore, granulocyte-colony stimul ating (G-CSF) factor was administered in order to reduce neutropenia relate d to docetaxel Docetaxel was administered intravenously at a dose of 100 mg /m(2), on day 1, and it was repeated every 3 weeks. G-CSF was administered for primary prophylaxis of neutropenia at the standard dose of 30 mg/day fr om day 4 to day 10 of each cycle. The treatment was tolerated well and 5 (2 1.7%) partial responses were obtained. The median rime to progression and t he median survival time were 3 and 5 months, respectively. The main side ef fect noted was fatigue, the intensity of which was grade 2 in 43.4% of case s and grade 3 in 8.7% of patients, respectively. One patient (4.3%) had gra de 4 cutaneous toxicity. No cases of grade 4 neutropenia were reported. In conclusion, docetaxel is active when used for salvage chemotherapy in advan ced NSCLC whilst concurrent primary prophylactic administration of granuloc yte-colony stimulating factor seems to decrease severe neutropenia.