In a nutshell
This trial examined whether altering the recommended dose of chemotherapy drugs during treatment was beneficial to patients. This trial concluded that altering doses of paclitaxel (Taxol) during chemotherapy could be beneficial to reduce neuropathy in patients with advanced non-small-cell lung cancer.
Some background
One important aspect of treating patients with chemotherapy is choosing a dose with maximum effectiveness and minimum toxicity. Currently, paclitaxel combined with another platinum-based chemotherapy drug is commonly used to treat patients with advanced non-small-cell lung cancer (NSCLC). Toxic side effects, such a neutropenia (low amount of white blood cells) and neuropathy (damage to nerves), are common however. It is possible that altering paclitaxel dose during treatment based on individual patient factors may have less toxic side effects during treatment.
Methods & findings
365 patients with advanced NSCLC were included. 182 patients in group A were treated with the current recommended dose of paclitaxel. 183 patients in group B were treated with an initial dose based on body surface area, age and sex. This dose was then altered throughout the therapy based on levels of neutropenia. The average follow up was 21.6 months.
The average paclitaxel dose was lower in group B. Rates of severe neutropenia were not different between group A and B. Moderate neuropathy rates were significantly lower in group B (23%) compared to group A (38%). The rates of serious neuropathy were also significantly lower in group B (2%) compared to group A (9%). Response to treatment, disease control rate and overall survival was similar in both groups. Average overall survival was 10.1 months for group A and 9.5 months for group B.
The bottom line
The authors concluded that altering the dose of paclitaxel during treatment did not improve neutropenia but did reduce neuropathy, which could benefit patients’ quality of life.
The fine print
This study was funded by Saladex Biomedical Inc., the manufacturers of paclitaxel.
Published By :
Annals of oncology
Date :
Aug 08, 2016
