Weekly docetaxel in the treatment of elderly patients with advanced nonsmall cell lung carcinoma - A Minnie Pearl Cancer Research Network Phase II trial

BACKGROUND. Weekly administration of docetaxel was found to reduce myelosup pression and other nonhematologic toxicities when compared with administrat ion every 3 weeks. In the current Phase II trial, the authors evaluated the feasibility, toxicity, and efficacy of weekly docetaxel in the treatment o f elderly patients with newly diagnosed advanced nonsmall cell lung carcino ma. METHODS, Thirty-nine patients with advanced, previously untreated nonsmall cell lung carcinoma entered this Phase II trial between February 1998 and J anuary 1999. Patients were required either to be age greater than or equal to 65 years or to be poor candidates for combination chemotherapy due to co existent medical illnesses. All patients received docetaxel, 36 mg/m(2), ad ministered weekly for 6 consecutive weeks, followed by 2 weeks without trea tment. Patients were reevaluated after 8 weeks of treatment; responding pat ients continued weekly docetaxel for a maximum of 32 weeks or until disease progression. RESULTS, Weekly docetaxel was well tolerated by this elderly group of patie nts with nonsmall cell lung carcinoma. Grade 3 leukopenia was noted in only 3 patients (8%), and no patient developed Grade 4 myelosuppression. Grade 3/4 nonhematologic toxicity also was uncommon; fatigue/asthenia was reporte d in 4 patients (10%). Seven of 38 evaluable patients (18%) had objective r esponses to weekly docetaxel whereas an additional 13 patients (34%) had a minor response or stable disease at first reevaluation. The median survival in this group of elderly patients was 5 months, with a 1-year actuarial su rvival rate of 27'%. CONCLUSIONS. The results of the current study show that weekly docetaxel is active and well tolerated in elderly patients with advanced nonsmall cell lung carcinoma and provides an additional treatment option for these patien ts, who often tolerate combination chemotherapy regimens poorly. (C) 2000 A merican Cancer Society.