Cancer Chemotherapy and Pharmacology

, Volume 52, Issue 1, pp 19–24

Combination second-line chemotherapy with gemcitabine and docetaxel for recurrent non-small-cell lung cancer after platinum-containing chemotherapy: a phase I/II trial

  • Seiji Niho
  • Kaoru Kubota
  • Koichi Goto
  • Hironobu Ohmatsu
  • Taketoshi Matsumoto
  • Ryutaro Kakinuma
  • Yutaka Nishiwaki
Original Article

Abstract

Purpose

In a randomized trial, docetaxel monotherapy yielded longer survival than the best supportive care in patients with non-small-cell lung cancer (NSCLC) previously treated with platinum-based chemotherapy, and combination chemotherapy regimens containing docetaxel have been assessed to enhance the efficacy of second-line chemotherapy. We conducted a phase I/II trial of gemcitabine and docetaxel in patients with recurrent NSCLC after platinum-based chemotherapy and with an ECOG performance status (PS) of 0 or 1.

Patients and methods

Docetaxel administration was fixed at a dosage of 60 mg/m2 on day 8, and gemcitabine was administered on days 1 and 8. The starting dose level of gemcitabine was 800 mg/m2 (level 0), and the subsequent dose level of gemcitabine was 1000 mg/m2 (level +1). Treatment was repeated every 3 weeks.

Results

In the phase I study, 13 patients were enrolled, and in the phase II study, 29 patients were enrolled. Neutropenic fever and omission of treatment on day 8 due to leukopenia (leukocyte count less than 3000/mm3) were dose-limiting toxicities (DLTs). Three of six patients experienced DLTs at level +1, which was the maximum tolerated dose. Gemcitabine 800 mg/m2 on days 1 and 8 plus docetaxel 60 mg/m2 on day 8 (level 0) was recommended for the phase II study. An objective response was observed in 8 (28%) of the 29 patients. The median time to disease progression was 4.2 months (95% CI 0.9–7.7 months). The median survival time was 11.1 months (95% CI 9.9–12.4 months), and the 1-year survival rate was 41%. The most common toxicity, though mild, was hematologic, and consisted of grade 4 neutropenia (18%), grade 3 febrile neutropenia (11%), and grade 3 thrombocytopenia (11%). There were no toxic deaths. Grade 3 non-hematologic toxicities included nausea (4%) and rash (4%).

Conclusions

The combination chemotherapy of gemcitabine and docetaxel is active and well tolerated in patients with recurrent NSCLC after platinum-based chemotherapy and with a good PS.

Keywords

Gemcitabine Docetaxel Second-line Non-small-cell lung cancer 

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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Seiji Niho
    • 1
  • Kaoru Kubota
    • 1
  • Koichi Goto
    • 1
  • Hironobu Ohmatsu
    • 1
  • Taketoshi Matsumoto
    • 1
  • Ryutaro Kakinuma
    • 1
  • Yutaka Nishiwaki
    • 1
  1. 1.Division of Thoracic OncologyNational Cancer Center Hospital EastChibaJapan

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