Triplet chemotherapy with cisplatin, docetaxel, and irinotecan for patients with recurrent or refractory non-small cell lung cancer

Nobukazu Fujimoto; Katsuyuki Kiura; Nagio Takigawa; Yoshiro Fujiwara; Shinichi Toyooka; Shigeki Umemura; Masahiro Tabata; Hiroshi Ueoka; Mitsune Tanimoto

doi:10.18926/AMO/32866

Triplet chemotherapy with cisplatin, docetaxel, and irinotecan for patients with recurrent or refractory non-small cell lung cancer

Acta Med Okayama. 2010 Feb;64(1):33-7. doi: 10.18926/AMO/32866.

Authors

Nobukazu Fujimoto¹, Katsuyuki Kiura, Nagio Takigawa, Yoshiro Fujiwara, Shinichi Toyooka, Shigeki Umemura, Masahiro Tabata, Hiroshi Ueoka, Mitsune Tanimoto

Affiliation

¹ Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital, Okayama 700-8558, Japan.

PMID: 20200582
DOI: 10.18926/AMO/32866

Abstract

We examined the feasibility of triplet chemotherapy using cisplatin, docetaxel, and irinotecan for patients with recurrent or refractory non-small cell lung cancer (NSCLC), retrospectively. Twenty-five patients (21 men and 4 women) with NSCLC and good performance status who were < or = 70 years old were analyzed. The median age was 58 years. Most patients had performance status 1 (16/25), stage IV disease (18/25) and adenocarcinoma-histology (16/25). Cisplatin and docetaxel were given on day 1 and irinotecan on day 2; the cycle was repeated every 3 weeks. The objective response rate was 39.1% (95% confidence interval: 18.7-59.5%). The median survival time and actual 2-, 3-, and 5-year survival rates were 14.3 months, 32%, 20%, and 8%, respectively. Of note, only 6 patients were treated with gefitinib at the recurrence after triplet chemotherapy; of these, 4 (67%) achieved a partial response, which might result in favorable survival. Grade 3/4 toxicities consisted of neutropenia (100%), neutropenic fever (56%), nausea/vomiting (40%), and diarrhea (16%); no cases of treatment-related death occurred. Triplet chemotherapy showed impressive survival data in our clinical trial, but proved too toxic for use in treating patients with NSCLC in the clinical practice.

MeSH terms

Adenocarcinoma / drug therapy
Adenocarcinoma / mortality
Adult
Aged
Antineoplastic Agents, Phytogenic / administration & dosage
Antineoplastic Agents, Phytogenic / adverse effects
Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
Antineoplastic Combined Chemotherapy Protocols / adverse effects*
Camptothecin / administration & dosage
Camptothecin / adverse effects
Camptothecin / analogs & derivatives
Carcinoma, Large Cell / drug therapy
Carcinoma, Large Cell / mortality
Carcinoma, Non-Small-Cell Lung / drug therapy*
Carcinoma, Non-Small-Cell Lung / mortality
Carcinoma, Signet Ring Cell / drug therapy
Carcinoma, Signet Ring Cell / mortality
Carcinoma, Squamous Cell / drug therapy
Carcinoma, Squamous Cell / mortality
Cisplatin / administration & dosage
Cisplatin / adverse effects
Docetaxel
Female
Follow-Up Studies
Gefitinib
Humans
Irinotecan
Lung Neoplasms / drug therapy*
Lung Neoplasms / mortality
Male
Middle Aged
Neoplasm Recurrence, Local / drug therapy*
Neoplasm Recurrence, Local / mortality
Quinazolines / administration & dosage
Quinazolines / adverse effects
Retrospective Studies
Survival Analysis
Taxoids / administration & dosage
Taxoids / adverse effects

Substances

Antineoplastic Agents, Phytogenic
Quinazolines
Taxoids
Docetaxel
Irinotecan
Cisplatin
Gefitinib
Camptothecin