Weekly Paclitaxel in Elderly Lung Cancer Patients an Option

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http://www.cancerpage.com/news/article.asp?id=12619

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NEW YORK SEPT 04, 20028 (Reuters Health) - Weekly administration of paclitaxel, in combination with carboplatin, has similar efficacy as the standard (every 3 week) regimen of paclitaxel and carboplatin for elderly patients with advanced nonsmall cell lung cancer (NSCLC), a study shows.

Moreover, the weekly regimen "has the advantage of less side effects and overall better tolerability," Dr. Chandra P. Belani, deputy director of the Penn State Cancer Institute in Hershey, Pennsylvania, told Reuters Health.

Paclitaxel when given weekly, she added, "has a better therapeutic index," especially in the elderly who are more prone to increased side effects from chemotherapy."

Dr. Belani and colleagues reviewed the records of 136 patients age 70 or older with advanced NSCLC who were randomly assigned to the weekly schedule (paclitaxel, 100 mg/m2 weekly for 3 of 4 weeks and carboplatin on day 1 every 4 weeks) or to the standard schedule (paclitaxel, 225 mg/m2 and carboplatin on day 1 every 21 days).

The survival rates were similar between the two groups, the investigators report in the August 1st issue of the journal Cancer. However, the response rate was 26% on the weekly regimen and 19% on the standard schedule.

The median length of survival for the weekly and the standard schedules was 37 weeks and 31 weeks, respectively, and the 1-year survival rates were 31% and 33%, respectively.

"Overall, there were a few important advantages with the weekly schedule, most notably the lower incidence of neuropathy for elderly patients," they add.

Grade 3 neuropathy was seen in 5.5% of patients in the weekly paclitaxel arm compared with 9.5% of those in the 3-week arm. Nausea and emesis were also less common with the weekly schedule. Grade 3 to 4 anemia, however, was more common with weekly paclitaxel (16% vs 6%).

Given the similar efficacy, weekly paclitaxel schedule "may be advantageous based on its favorable tolerability profile," the investigators conclude.

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(Cancerpage.com, Source: Cancer, 113:542-546, Reuters Health Information, September 4, 2008)

Disclaimer:

The information contained in these articles may or may not be in agreement with my own opinions. They are not posted as medical advice of any kind.