Docetaxel in the management of advanced non-small cell lung cancer

Following encouraging phase I trials in non-small cell lung cancer, the semisynthetic taxoid docetaxel has been extensively studied in the phase 11 setting, most commonly using a dose of 100 mg/m2 every 3 weeks. Major objective response rates range from 21% to 38% in previously untreated patients. The pooled response rate is 29% and median survival is nearly 11 months. In combination with cisplatin, docetaxel achieves a pooled response rate of approximately 40%, with neutropenia the dose-limiting toxicity. However, the median survival durations achieved do not clearly exceed those with docetaxel monotherapy. Based on preclinical evidence of synergy, docetaxel also has been combined with vinorelbine and, using prophylactic granulocyte colony-stimulating factor, it has been possible to escalate the doses of both drugs to single-agent phase II dose intensity.