John Libbey Eurotext

Bulletin du Cancer


Sequential administration of docetaxel followed by cisplatin-vindesine: a pilot study in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) Volume 92, numéro 1, Janvier 2005

Service d’oncologie, hôpital Pitié-Salpêtrière, 47 boulevard de l’Hôpital, 75013 Paris, France, Service de pneumologie et réanimation respiratoire, hôpital Pitié Salpêtrière, Paris, France, Clinique Hartmann, Neuilly sur Seine, France, Aventis Pharma, Antony Cedex, France
  • Mots-clés : sequential, docetaxel, cisplatin, vindesine, non small cell lung cancer
  • Page(s) : 10001-6
  • Année de parution : 2005

In this phase II study, the feasibility and efficacy of sequential chemotherapy were tested with agents shown to be active as monotherapy. Patients with chemotherapy-naïve, locally advanced or metastatic non-small cell lung cancer were selected for the study. Treatment involved four cycles of docetaxel (100 mg/m 2 on day 1, every 3 weeks) (sequence A), followed by four cycles of cisplatin–vindesine (cisplatin 120 mg/m 2 on day 1 and vindesine 3 mg/m 2 on days 1, 8, 15, and 22, every 4 weeks) (sequence B). Responding patients received 3 cycles of docetaxel 100 mg/m 2 (day 1, every 3 weeks) as consolidation (sequence C). Thirty-two patients entered the study with thirty being evaluable for efficacy. Four patients showed a partial response and one patient a complete response, resulting in an objective response rate of 16.7 %. The median survival time (intent-to-treat) was 11 months (95 %CI = 8.0–15.4 months) with an estimated 1-year survival rate of 47%. The median time to progression was 17.6 weeks in the evaluable population. Main grade 4 toxicity was neutropenia (21.8 % and 68.2 % of patients in sequence A and B, respectively) while grade 3 peripheral neuropathy was documented in five patients during sequence B. There were no treatment-related deaths. Sequential chemotherapy may show promise for the treatment of advanced non-small cell lung cancer. Given the feasibility of this pilot study, sequential chemotherapy concept should be investigated with newer cisplatin-based regimens using this approach in larger prospective studies.