Front line chemotherapy in advanced NSCLC with paclitaxel and irinotecan combination

Abstract

7127 Background: Non-small cell lung cancer (NSCLC) patients of advanced stage are still of a need for new chemotherapy schedules to improve response rate and overall survival. There are new agents that have been established effectively in other tumors but very little applied in NSCLC. In the last category belong camptothecins. Methods: The objective of the present study was to combine one established first line cytotoxic agent - paclitaxel with a-camptothecin agent, irinotecan. 51 patients have already been enrolled since the beginning of April 2003 till December 5, 2003. They were all naïve of any previous treatment. 38 patients are evaluable for response rate. Of those 33 were male and 5 female median age 61 - range 35–77. Performance status 0–2. Stage IIIb and IV.Irinotecan 100mg/m2 90min infusion, paclitaxel 135 mg/m2 3 hour infusion, both administered on day 1 and repeated every two weeks. The plan was to give 9 cycles per patient and evaluation by CT-Scan to be performed after the 4th or 5th cycle. The total number of cycles given till now was 187 and the mean 4.92. Patients stopped treatment in case of disease progression or intolerable toxicity. Results: Myelotoxicity was seen in the majority of the patients but only in 4 patients (10.53%) was of Grade III and IV. Of the non-hematologic toxicity nausea and vomiting was negligible, diarrhea of Grade III was only seen in 5 patients (13.16%). Neurotoxicity of Grade I was common. No other serious toxicity was observed. No complete remission was seen. Partial remission was detected in 18 patients (42.11%), stable disease in 16 patients (38%) and disease progression in 4 patients (10.53%). The median survival has not yet been reached. There are 7 events till Dec.03 (18.42%), in 8 months of follow-up. Conclusions: The combination of Paclitaxel and Irinotecan every two weeks in untreated NSCLC patients of stage IIIb and IV is effective with 42.11% response rate and acceptable toxicity. No significant financial relationships to disclose.