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Neoadjuvant Docetaxel (Taxotere) Improves Life Expectancy In Locally Advanced Lung Cancer: Presented at DG DISPATCH - LUNG CANCER

By Jill Stein
Special to DG News
TOKYO, JAPAN -- September 12, 2000 -- The use of docetaxel (Taxotere) as neoadjuvant therapy prior to local treatment improves survival over local treatment alone in patients with locally advanced non-small cell lung cancer (NSCLC).
Dr. Karin Mattson, with the University Hospital of Helsinki, in Helsinki, Finland, and colleagues elsewhere, studied results in 274 men and women with stage III NSCLC. They presented their phase III results at the Ninth World Conference on Lung Cancer, in Tokyo, Japan.
One group received intravenous docetaxel, 100 mg/m², administered once every three weeks for three consecutive cycles, followed by local treatment involving radical surgery or radiotherapy. A second group underwent immediate local treatment alone.
Patients were stratified by disease stage. The choice of local therapy was made by the treating physician. All patients in the trial were considered candidates for surgery or radiation therapy.
The two treatment arms were similar with respect to the ratio of men to women, median age, World Health Organization (WHO) performance status, tumor histology and disease stage.
Results showed that the median length of survival was longer in patients who received neoadjuvant docetaxel prior to local treatment compared with patients who received local treatment alone (15 months versus 13 months for the two groups, respectively).
Median survival in IIIA T3 patients who received docetaxel was significant longer than that of the control group (19 months versus 13 months for the two groups, respectively).
Neoadjuvant docetaxel was generally well tolerated. Febrile neutropenia was uncommon, non-hematologic toxicities were acceptable and predictable, the researchers said.
The use of docetaxel did not have a deleterious effect on the ability of patients to receive definitive therapy. Notably, there was no difference in the two treatment groups in the rate of radiation-associated pneumonitis and esophagitis.
Dr. Mattson said the results demonstrate that docetaxel administered as a single agent is effective and generally well-tolerated when used as a neoadjuvant treatment in stage III NSCLC. In addition, the findings provide support for earlier trials, which suggested that these patients should receive combined modality treatment rather than local treatment alone, which had been the treatment standard.
Finally, Dr. Mattson emphasized that neoadjuvant therapy has previously involved drug combinations, including the drug cisplatin, which are "relatively unpleasant" for patients. "The availability of a proven neoadjuvant treatment that avoids the use of cisplatin is an important advance."
The trial is the largest randomized study to date to examine the role of neoadjuvant therapy in stage III patients with lung cancer.
Related Link: docetaxel (Taxotere).

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