Docetaxel and non small-cell lung cancer: new indication. One of several non curative chemotherapies

(1) The reference treatment for non small-cell lung cancer is surgery. Chemotherapy is not curative in advanced stages, and yields only a moderate benefit. (2) Docetaxel, a cytotoxic drug, is now licensed for the treatment of locally advanced or metastatic non small-cell lung cancer after failure of chemotherapy. (3) The clinical file is based on two randomised, comparative but unblinded trials. (4) In one trial, involving 104 patients, docetaxel (one infusion of 75 mg/m2 every three weeks) increased median survival by 3 months compared with good palliative care, and reduced the incidence of severe pain and wasting. (5) In the other trial, involving 373 patients, median survival was the same (6 months) on docetaxel as on vinorelbine or ifosfamide. (6) Apart from its haematological toxicity, the most troublesome adverse effects of docetaxel are oedema, skin and nail changes, and hypersensitivity reactions.