Weekly chemotherapy for lung cancer – pro

Palliative chemotherapy for metastatic lung cancer is now standard. Platinum-based combinations were the first regimens to convincingly have an impact on survival and have been the standard of care in NSCLC. A European study showed that gemcitabine/cisplatin was essentiall equivalent to paclitaxel and a platin and the former became standard in Europe whereas the latter is most often used in the USA. More recently Avastin has been shown to add to the survival benefit. Taxotere has been established as roughly equivalent to Taxol in a phase III trial.

The question is weekly dosing vs the more common three-weekly schedule.It is known that administration of Paraplatin® on either day 1 or day 8 does not alter the therapeutic index of the Gemzar®-Paraplatin® doublet for the treatment of advanced NSCLC. The use of paclitaxel plus carboplatin, administered in a novel weekly regimen, offers a safe and effective treatment option for patients with advanced lung cancer, according to research presented at the 37th Annual Meeting of the American Society of Clinical Oncology. Weekly paclitaxel and carboplatin were also the standard arm of the Tibute trial. In October, 2009 a randomized study supporting weekly dosing was reported.

Based on these studies,  weekly dosing is already in wide use. I therefore do not consider it experimental.

C. Camps  et al, Randomized phase III study of 3-weekly versus weekly docetaxel in pretreated advanced non-small-cell lung cancer: a Spanish Lung Cancer Group trial Ann Oncol (March 2006) 17 (3): 467-472

T. Sakakibara , A. Inoue , S. Sugawara , M. Maemondo , T. Ishida , K. Usui , T. Abe , M. Kanbe , H. Watanabe , Y. Saijo , and T. Nukiwa
Randomized phase II trial of weekly paclitaxel combined with carboplatin versus standard paclitaxel combined with carboplatin for elderly patients with advanced non-small-cell lung cancer Annals of Oncology Advance Access published on October 8, 2009, DOI 10.1093/annonc/mdp401.
Kallab, Andre et al, A phase II study of weekly paclitaxel and carboplatin in previously untreated patients with advanced non-small-cell lung cancer
Medical Oncology, Volume 22, Number 2, June 2005 , pp. 145-151(7)

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