Prophylactic G-CSF and antibiotics enable a significant dose-escalation of triplet-chemotherapy in non-small cell lung cancer.

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Publication year
2008Source
Lung Cancer, 60, 2, (2008), pp. 222-230ISSN
Publication type
Article / Letter to editor

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Organization
Pulmonary Diseases
Medical Oncology
Radiology
Radiation Oncology
Journal title
Lung Cancer
Volume
vol. 60
Issue
iss. 2
Page start
p. 222
Page end
p. 230
Subject
NCMLS 2: Immune Regulation; ONCOL 1: Hereditary cancer and cancer-related syndromes; ONCOL 2: Age-related aspects of cancer; ONCOL 3: Translational research; ONCOL 5: Aetiology, screening and detection; UMCN 1.1: Functional Imaging; UMCN 1.5: Interventional oncology; UMCN 4.1: Microbial pathogenesis and host defenseAbstract
In advanced non-small cell lung cancer (NSCLC) the clinical benefit of a platinum-based doublet is only modest, therefore, attenuated dosed three-drug combinations are investigated. We hypothesized that with adequate support a full dosed chemotherapy triplet is feasible. The study was designed as a dose finding study of paclitaxel in chemotherapy-naive patients. Paclitaxel was given as a 3-h infusion on day 1, followed by fixed doses of teniposide (or etoposide) 100mg/m(2) days 1, 3, 5 and cisplatin 80 mg/m(2) day 1 every 3 weeks. As myelotoxicity was expected to be the dose-limiting toxicity, prophylactic G-CSF and antibiotic support was evaluated. Indeed, paclitaxel 120 mg/m(2) resulted in dose-limiting neutropenia, despite G-CSF support. Teniposide/etoposide day 1, 3, 5 was less myelotoxic compared to day 1, 2, 3. G-CSF support allowed paclitaxel dose-escalation to 250 mg/m(2). The addition of prophylactic antibiotics enabled dose-escalation to 275 mg/m(2) without reaching MTD. In conclusion, G-CSF and antibiotics prophylaxis enables the delivery of a full dosed chemotherapy triplet in previously untreated NSCLC patients.
This item appears in the following Collection(s)
- Academic publications [204968]
- Electronic publications [103219]
- Faculty of Medical Sciences [81049]
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