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Weekly carboplatin in combination with weekly paclitaxel in the treatment of metastatic non-small cell lung cancer: a single center 10-year experience

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Abstract

Purpose

The primary objective of this retrospective analysis is to assess efficacy and toxicity of a chemotherapeutic regimen using weekly carboplatin in combination with weekly paclitaxel as first-line therapy for advanced/metastatic non-small cell lung cancer (NSCLC).

Methods

All patients with stage IIIB/IV NSCLC treated with weekly carboplatin AUC (area under the curve) 3 days 1, 8, 15, q4w in combination with weekly paclitaxel 75 mg/m2 days 1, 8, 15, q4w as first-line therapy at the Kantonsspital Graubuenden between August 2004 and May 2014 were retrospectively analyzed by medical record review.

Results

A total of 90 patients were treated. Median age was 66 years (range 39–88). A total of 229 chemotherapy cycles were administered. Hematological and non-hematological toxicity were acceptable allowing for a median relative dose intensity for all planned treatment cycles of 76 %. Overall response rate was 34 %. Median overall and progression free survival was 6.3 (95 % CI, 4.9–8.7) and 3.4 (95 % CI, 2.3–5.1) months, respectively. Patients with an ECOG performance score (PS) of 0 or 1 had a significantly better OS compared to patients with a PS of ≥2. No statistically significant difference was observed in patients younger or older than 70 years of age.

Conclusions

Weekly carboplatin in combination with weekly paclitaxel results in good response rates and acceptable toxicity in patients with advanced and metastatic NSCLC including patients with poor risk features (brain metastases, older age, and impaired PS). Nonetheless, selecting the right patient for a platinum-based combination treatment remains an important task in clinical practice.

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References

  1. Reck M, Popat S, Reinmuth N et al (2014) Metastatic non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 25:iii27–iii39. doi:10.1093/annonc/mdu199

    Article  PubMed  Google Scholar 

  2. Schiller JH, Schiller JH, Harrington D et al (2002) Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med 346:92–98. doi:10.1056/NEJMoa011954

    Article  CAS  PubMed  Google Scholar 

  3. Kelly K, Crowley J, Bunn PA et al (2001) Randomized phase III trial of paclitaxel plus carboplatin versus vinorelbine plus cisplatin in the treatment of patients with advanced non-small-cell lung cancer: a Southwest Oncology Group trial. J Clin Oncol 19:3210–3218

    Article  CAS  PubMed  Google Scholar 

  4. Lilenbaum RC, Herndon JE, List MA et al (2005) Single-agent versus combination chemotherapy in advanced non-small-cell lung cancer: the cancer and leukemia group B (study 9730). J Clin Oncol 23:190–196. doi:10.1200/JCO.2005.07.172

    Article  CAS  PubMed  Google Scholar 

  5. Sandler A, Gray R, Perry MC et al (2006) Paclitaxel–carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 355:2542–2550. doi:10.1056/NEJMoa061884

    Article  CAS  PubMed  Google Scholar 

  6. Belani CP, Ramalingam S, Perry MC et al (2008) Randomized, phase III study of weekly paclitaxel in combination with carboplatin versus standard every-3-weeks administration of carboplatin and paclitaxel for patients with previously untreated advanced non-small-cell lung cancer. J Clin Oncol 26:468–473. doi:10.1200/JCO.2007.13.1912

    Article  CAS  PubMed  Google Scholar 

  7. Jennens RR, Giles GG, Fox RM (2006) Increasing underrepresentation of elderly patients with advanced colorectal or non-small-cell lung cancer in chemotherapy trials. Intern Med J 36:216–220. doi:10.1111/j.1445-5994.2006.01033.x

    Article  CAS  PubMed  Google Scholar 

  8. Hutchins LF, Unger JM, Crowley JJ et al (1999) Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med 341:2061–2067. doi:10.1056/NEJM199912303412706

    Article  CAS  PubMed  Google Scholar 

  9. Foeglé J, Hédelin G, Lebitasy MP et al (2005) Non-small-cell lung cancer in a French department, (1982–1997): management and outcome. Br J Cancer 92:459–466. doi:10.1038/sj.bjc.6602342

    PubMed  PubMed Central  Google Scholar 

  10. Quoix E, Zalcman G, Oster J-P et al (2011) Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial. Lancet 378:1079–1088. doi:10.1016/S0140-6736(11)60780-0

    Article  CAS  PubMed  Google Scholar 

  11. Maemondo M, Inoue A, Sugawara S et al (2014) Randomized phase II trial comparing carboplatin plus weekly paclitaxel and docetaxel alone in elderly patients with advanced non-small cell lung cancer: north Japan lung cancer group trial 0801. Oncologist 19:352–353. doi:10.1634/theoncologist.2013-0411

    Article  PubMed  PubMed Central  Google Scholar 

  12. D’Addario G, Morant R, Boehme C, Cerny T (2002) Feasibility and toxicity of weekly paclitaxel–carboplatin in 131 patients with pretreated and non-pretreated solid tumors. Onkologie 25:152–157. doi:10.1159/000055225

    PubMed  Google Scholar 

  13. Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41. doi:10.1159/000180580

    Article  CAS  PubMed  Google Scholar 

  14. Hryniuk W, Bush H (1984) The importance of dose intensity in chemotherapy of metastatic breast cancer. J Clin Oncol 2:1281–1288

    Article  CAS  PubMed  Google Scholar 

  15. Belani CP (2003) Multicenter, randomized trial for stage IIIB or IV non-small-cell lung cancer using weekly paclitaxel and carboplatin followed by maintenance weekly paclitaxel or observation. J Clin Oncol 21:2933–2939. doi:10.1200/JCO.2003.02.563

    Article  CAS  PubMed  Google Scholar 

  16. Schuette W, Schuette W, Blankenburg T et al (2006) Multicenter randomized trial for stage IIIB/IV non-small-cell lung cancer using every-3-week versus weekly paclitaxel/carboplatin. Clin Lung Cancer 7:338–343. doi:10.3816/CLC.2006.n.016

    Article  CAS  PubMed  Google Scholar 

  17. Seidman AD, Berry D, Cirrincione C et al (2008) Randomized phase III trial of weekly compared with every-3-weeks paclitaxel for metastatic breast cancer, with trastuzumab for all HER-2 overexpressors and random assignment to trastuzumab or not in HER-2 nonoverexpressors: final results of Cancer and Leukemia Group B protocol 9840. J Clin Oncol 26:1642–1649. doi:10.1200/JCO.2007.11.6699

    Article  CAS  PubMed  Google Scholar 

  18. Kelly K, Chansky K, Mack PC et al (2013) Chemotherapy outcomes by histologic subtypes of non-small-cell lung cancer: analysis of the Southwest Oncology Group Database for antimicrotubule-platinum therapy. Clin Lung Cancer 14:627–635. doi:10.1016/j.cllc.2013.06.010

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. (1999) Effects of vinorelbine on quality of life and survival of elderly patients with advanced non-small-cell lung cancer. The Elderly Lung Cancer Vinorelbine Italian Study Group. JNCI Journal of the National Cancer Institute 91:66–72.

  20. D’Addario G, Früh M, Reck M et al (2010) Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):v116–v119. doi:10.1093/annonc/mdq189

    Article  PubMed  Google Scholar 

  21. Belotti D, Vergani V, Drudis T et al (1996) The microtubule-affecting drug paclitaxel has antiangiogenic activity. Clin Cancer Res 2:1843–1849

    CAS  PubMed  Google Scholar 

  22. Browder T, Butterfield CE, Kräling BM et al (2000) Antiangiogenic scheduling of chemotherapy improves efficacy against experimental drug-resistant cancer. Cancer Res 60:1878–1886

    CAS  PubMed  Google Scholar 

  23. Linderholm BK, Lidbrink E, Tallroth E et al (2013) Angiogenic factors in relation to clinical effect in a phase II trial of weekly paclitaxel. Breast 22:1142–1147. doi:10.1016/j.breast.2013.07.041

    Article  CAS  PubMed  Google Scholar 

  24. Reck M, von Pawel J, Zatloukal P et al (2009) Phase III trial of cisplatin plus gemcitabine with either placebo or bevacizumab as first-line therapy for nonsquamous non-small-cell lung cancer: AVAiL. J Clin Oncol 27:1227–1234. doi:10.1200/JCO.2007.14.5466

    Article  CAS  PubMed  Google Scholar 

  25. Socinski MA, Langer CJ, Okamoto I et al (2013) Safety and efficacy of weekly nab®-paclitaxel in combination with carboplatin as first-line therapy in elderly patients with advanced non-small-cell lung cancer. Ann Oncol 24:314–321. doi:10.1093/annonc/mds461

    Article  CAS  PubMed  Google Scholar 

  26. Socinski MA, Bondarenko I, Karaseva NA et al (2012) Weekly nab-paclitaxel in combination with carboplatin versus solvent-based paclitaxel plus carboplatin as first-line therapy in patients with advanced non-small-cell lung cancer: final results of a phase III trial. J Clin Oncol 30:2055–2062. doi:10.1200/JCO.2011.39.5848

    Article  CAS  PubMed  Google Scholar 

  27. Untch M, Jackisch C, Schneeweiss A et al (2015) Abstract S2-07: A randomized phase III trial comparing neoadjuvant chemotherapy with weekly nanoparticle-based paclitaxel with solvent-based paclitaxel followed by anthracyline/cyclophosphamide for patients with early breast cancer (GeparSepto); GBG 69. Cancer Res 75:S2–07–S2–07. doi:10.1158/1538-7445.SABCS14-S2-07

    Article  Google Scholar 

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Author notes

    Authors and Affiliations

    1. Department of Internal Medicine III, University of Bonn, Bonn, Germany

      Viktoria Volk & Peter Brossart

    2. Department of Medical Oncology and Hematology, Kantonsspital Graubünden, Loestrasse 170, CH-7000, Chur, Switzerland

      Richard Cathomas, Michael Mark, Roger von Moos & Ulrich Mey

    3. Statistics Unit, SAKK Swiss Group for Cancer Research Coordinating Center, Bern, Switzerland

      Dirk Klingbiel

    Authors
    1. Viktoria Volk
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    2. Richard Cathomas
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    3. Michael Mark
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    Correspondence to Ulrich Mey.

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    The authors declare that they have no competing interests.

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    This retrospective analysis was approved by the Swiss Department of Health.

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    Viktoria Volk and Richard Cathomas contributed equally to this work.

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    Volk, V., Cathomas, R., Mark, M. et al. Weekly carboplatin in combination with weekly paclitaxel in the treatment of metastatic non-small cell lung cancer: a single center 10-year experience. Support Care Cancer 24, 2119–2128 (2016). https://doi.org/10.1007/s00520-015-3015-z

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    • DOI: https://doi.org/10.1007/s00520-015-3015-z

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