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Keywords:

  • nonsmall cell lung carcinoma;
  • chemotherapy;
  • paclitaxel;
  • carboplatin;
  • irinotecan

Abstract

BACKGROUND

This Phase II multicenter, open-label, single-arm study evaluated the efficacy and safety of a three-drug combination of irinotecan (CPT-11), paclitaxel, and carboplatin in advanced nonsmall cell lung carcinoma (NSCLC).

METHODS

Patients received repeated 21-day cycles at starting doses of paclitaxel 175 mg/m2 administered over 3 hours, followed by carboplatin AUC of 5 over 30 minutes and CPT-11 at a starting dose level of 100 mg/m2 over 90 minutes, all given on the first day of each cycle. Patients were evaluated for objective tumor response, time to tumor progression (TTP), survival, and safety.

RESULTS

Forty patients were enrolled. Baseline patient characteristics included: median age 58 years (range, 32–79); 23 males and 17 females; performance status of 0 (21 patients), 1 (18 patients), or 2 (1 patient); and Stage IIIB (10 patients) and Stage IV (30 patients) disease. A median of six cycles (range, one to eight) were administered. Grade 3–4 toxicities observed in ≥ 10% of the patients included neutropenia (78%), asthenia (20%), diarrhea (20%), nausea (18%), vomiting (13%), anemia (10%), and dyspnea (10%). Febrile neutropenia occurred in eight patients (20%), with one death due to neutropenic sepsis. Twelve of 38 evaluable patients had confirmed tumor responses (32%), while 21 (55%) had stable disease (including 12 patients [32%] with minor responses). Only 13% had disease progression at their initial tumor assessment. The median TTP and survival were 5.3 months (range, 0.03–6.2 months) and 12.5 months (range 0.3–28.6+ months), respectively. The one and two year survival probabilities were 0.50 (95% confidence interval [CI], 0.28–0.73) and 0.21 (95% CI, 0.0–0.67), respectively.

CONCLUSIONS

The combination of CPT-11, paclitaxel, and carboplatin can be safely administered and is active in the treatment of advanced NSCLC. Based on the favorable survival outcome, this regimen is undergoing evaluation in prospective randomized trials. Cancer 2002;95:1520–7. © 2002 American Cancer Society.

DOI 10.1002/cncr.10852