Paclitaxel, cisplatin, etoposide combination chemotherapy: a multifractionated bolus dose schedule for non-small cell lung cancer

• Published in: European journal of cancer (1990) 1998-04, Vol.34 (5), p.659-663
• Main Authors: Lokich, J, Anderson, N, Bern, M, Coco, F, Gotthardt, S, Oliynyk, P, Dow, E
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - drug therapy; Chemotherapy; Cisplatin - administration & dosage; Cisplatin - adverse effects; Dose Fractionation, Radiation; Etoposide - administration & dosage; Etoposide - adverse effects; etoposide combination; Female; Humans; lung cancer; Lung Neoplasms - drug therapy; Male; Medical sciences; Middle Aged; multifractionated dose schedule; Neutropenia - chemically induced; Paclitaxel - administration & dosage; Paclitaxel - adverse effects; Pharmacology. Drug treatments; platinol; Survival Analysis; taxol; Treatment Outcome
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/S0959-8049(97)10104-6

In this phase II study, paclitaxel was added to the combination of cisplatin and etoposide (TPE regimen), in 37 patients with advanced non-small cell lung cancer, using a multifractionated dosing schedule. The total dose of paclitaxel (175–200 mg/m 2); cisplatin (75 mg/m 2); and etoposide (175–200 mg/m 2) was divided into five daily doses administered over 3 h with cycles repeated at 21–28 days. 15 patients had stage III A or B disease and 22 stage IV disease. 32 patients were evaluable for toxicity and 37 for response. Neutropenia was the most prominent toxicity. Grade 3 or grade 4 neutropenia was observed in 12 (38%) and 9 (25%) of the patients, respectively and 11 patients required hospitalisation. 3 patients died secondary to chemotherapy related sepsis. Diarrhoea (grade 3, 3 patients; grade 4, 2 patients) was the only other significant non-haematological acute toxicity. The optimal dose rate 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/fraction. Responses were observed in 28 of 37 evaluable patients (3 complete response; 25 partial response [76%]. 22 patients are alive; 8 with stage III B disease received radiation or surgery (3 had minimal or no tumour in the pathology specimen). TPE is a highly active regimen for non-small cell lung cancer and multifractionated dose scheduling is a feasible and well tolerated system.