[Comparative safety evaluation of first- and second-line therapy with carboplatin + paclitaxel for advanced non-small...

The study was carried out to compare the incidence of hematological toxicity between 14 cases with CDDP+VNR as first line therapy followed by CBDCA+PTX as second-line therapy, and 21 cases with CBDCA+PTX as first-line therapy for nonsmall cell lung cancer. The incidences of thrombocytopenia were 78. 6% in the second-line and 42. 9% in the first-line with a significant difference (p=0. 0364). The incidences of neutropenia at grade 3 or more in the second-line and the first-line were 71. 4% and 52. 4%, respectively, with a tendency to be higher in the second-line. When creatinine values increased by 25%or more, even though they were within normal limits, following the CDDP+VNR in the first-line, the occurrence of neutropenia at grade 3 or more was significant (p=0. 016) in the first-course of the second-line therapy comprising CBDCA+PTX. The present findings suggest that when CBDCA+PTX therapy is performed following CDDP+VNR therapy, renal functions must be observed carefully, including changes in creatinine, during the CDDP+VNR therapy. When doses are determined for CBDCA+PTX as second-line therapy, dose reduction may be one of methods used to avoid serious hematological toxicity.