A feasibility study of postoperative adjuvant therapy of carboplatin and weekly paclitaxel for completely resected non-small cell lung cancer
Yoshinori Yamashita, Kazuhiko Kataoka, Teruyoshi Ishida, Motoki Matsuura, Noritomo Seno, Hidenori Mukaida, Eiji Miyahara, Yoshihiro Miyata, Riki Okita, Katsuhiko Shimizu, Masanobu Watari, Tsuneo Okumichi, Morihito Okada, Yoshinori Yamashita, Kazuhiko Kataoka, Teruyoshi Ishida, Motoki Matsuura, Noritomo Seno, Hidenori Mukaida, Eiji Miyahara, Yoshihiro Miyata, Riki Okita, Katsuhiko Shimizu, Masanobu Watari, Tsuneo Okumichi, Morihito Okada
Abstract
Introduction: Recent clinical trials have shown significant survival benefits from postoperative adjuvant therapy for respectable nonsmall cell lung cancer (NSCLC). However, evaluation of adjuvant chemotherapy with carboplatin combination is still uncertain. The purpose of the study was to test the feasibility of adjuvant chemotherapy with carboplatin and separate weekly paclitaxel after complete resection of pStage IB, II, IIIA NSCLC in a multicenter study.
Methods: The study was conducted from 2001 to 2006 in the outpatient setting. A total of 61 patients were enrolled. Patients received adjuvant chemotherapy with 4 cycles of carboplatin (AUC 5) on day 1 and paclitaxel (70 mg/m) on day 1, 8, and 15 every 4 weeks. Primary endpoints were toxicity and chemotherapy compliance. Secondary endpoints were disease-free survival and overall survival.
Results: More than 65% of eligible patients had pStage IIIA. The median number of chemotherapy cycles was 4 (range 1-4). Grade 3 or 4 toxicities of neutropenia were 34% (grade 4: 2%). Other hematologic adverse effects were extremely less frequent. Regarding the nonhematologic adverse effect, hair loss was frequent; however, peripheral neuralgia was less frequent. Treatment-related death was not registered. During median follow-up of 21 months, 24 patients developed recurrent disease. Estimated disease-free survival and overall survival at 2 years was 51.2% and 84.6%, respectively.
Conclusions: Postoperative carboplatin and weekly paclitaxel showed favorable feasibility and acceptable toxicity in comparison with the cisplatin-containing regimen. Consequently, it is desirable that this regimen would be validated in a phase III clinical trial for NSCLC after curative resection.
Source: PubMed