Several phase II studies have evaluated
docetaxel, administered as a 1-hour
intravenous infusion at a dose of 100 mg/m2 every 3 weeks, for
chemotherapy-naive patients with advanced
non-small cell lung cancer. Results have been consistent across numerous trials, with an overall response rate in the range of 23% to 38% and a median survival of 9 months. Results of a multicenter phase III trial of
docetaxel versus best supportive care for the first-line treatment of
non-small cell lung cancer are pending. In the second-line setting, after failure of first-line
platinum-based
chemotherapy, four phase II studies of
docetaxel 100 mg/m2 have achieved response rates ranging from 16% to 22%, with encouraging median survival times of 30 to 42 weeks. Preliminary results of a large, multicenter, randomized phase III trial also indicated an advantage for
docetaxel over control with regard to response, time to progression, survival, and quality of life. Results of a multicenter phase III trial of
docetaxel versus best supportive care as second-line treatment will be reported soon. Weekly
docetaxel has been well tolerated in phase I studies, with dose-limiting toxicity being
asthenia rather than myelosuppression. Phase II trials of a dosage of 36 mg/m2/wk in elderly patients with advanced
non-small cell lung cancer are ongoing.
Docetaxel is a potent radiosensitizer. The dose-limiting toxicity of
docetaxel when administered weekly with concurrent chest radiation at 50 to 64 Gy is
esophagitis. Phase II trials of weekly
docetaxel plus concomitant chest
radiotherapy are in progress at the recommended phase II dosage of 20 to 30 mg/m2/wk.