Docetaxel as second-line chemotherapy for advanced non-small cell lung cancer

The purpose of this study was to evaluate the efficacy and safety of docetaxel as second-line chemotherapy for advanced non-small cell lung cancer (NSCLC). Thirty-four patients with advanced NSCLC received docetaxel 75 mg/m2 (1-h intravenous infusion) every 3 weeks, with corticosteroid premedication. Of 28 evaluable cases, 18 were adenocarcinoma, 3 squamous cell, 3 large cell and 4 undifferentiated carcinoma. There were 16 male and 12 female patients with a median age of 55 (37-73) years and their median Karnofsky performance status was 70 per cent (60-90%). Five cases (19.2%) had liver metastases, 3 (11.5%) brain metastases, 6 (23%) bone metastases, and 17 (65.3%) metastatic nodules in the lung. Seventeen cases (50%) had received cisplatin-based and 12 (12/34, 35.3%) paclitaxel plus carboplatin prior to entering the present study. Besides chemotherapy, seven cases had received prior thoracic irradiation and two whole brain irradiation. Two cases had prior surgery for malignant pleural effusion and one had thoracotomy for the resection of the primary tumor. The time from the last dose of chemotherapy to the start of this study was less than 6 months in 20 cases, 6-12 months in 9, 12-24 months in 3 and more than 24 months in 2 cases. One patient with initial small cell lung cancer had developed NSCLC before entering this study. Three out of 28 cases achieved partial response (10.7%) and 13 out of 28 achieved stable disease (46.5%). The median survival time was 23.8 weeks. Neutropenia, grade 3 and 4 occurred in 38.8 per cent of all cycles. Skin rashes, diarrhea, asthenia, alopecia, neuropathy and edema were common non-hematologic toxicities. Docetaxel should be considered as second line chemotherapy in advanced NSCLC when primary chemotherapy including cisplatin and/or paclitaxel had failed.