Survival Outcome of Inoperable Non-Small Cell Lung Cancer Patients Receiving Conventional Dose Epirubicin and Paclitaxel as First-Line Treatment

Abstract

Objective: High-dose epirubicin was shown to be effective in the treatment of inoperable non-small cell lung cancer (NSCLC). Paclitaxel is synergistic to a conventional dose of anthracyclines in the treatment of advanced cancer. A phase II study was designed to test the effectiveness of combining paclitaxel with a conventional dose of epirubicin in inoperable NSCLC patients. Methods: Eligibility criteria included inoperable stage IIIB or IV NSCLC patients, Eastern Cooperative Oncology Group performance status of 0–2, measurable or evaluable disease and adequate organ function. Epirubicin 70 mg/m² intravenous infusion for 15 min was given on day 1. Paclitaxel 175 mg/m² intravenous infusion for 3 h was given on day 2. Cycles were repeated every 21 days. Tumor response was evaluated every two cycles. Patients received treatment until disease progression, unacceptable toxicity or stable disease after cycle 6. Results: Thirty-eight patients received a total of 185 cycles (median 6 cycles). Seventeen patients responded to treatment (response rate 44.7%). Twenty-six (68%) patients received second-line chemotherapy. All patients were followed until their death. Median survival was 11.9 months (95% confidence interval 9.0–14.9 months). Median time-to-treatment-failure was 4.6 months. Conclusion: Conventional dose epirubicin plus paclitaxel is effective as a first-line treatment for inoperable NSCLC patients.

Gemcitabine plus conventional-dose epirubicin versus gemcitabine plus cisplatin as first-line chemotherapy for stage IIIB/IV non-small cell lung carcinoma—A randomized phase II trial

“…Although the objective response rate of conventional-dose epirubicin (60-90 mg/m 2 per cycle) was generally lower [8,9], these lower dose of epirubicin may allow safer combination with other third-generation agents. We recently reported that epirubicin 70 mg/m 2 plus paclitaxel, 175 mg/m 2 every 3 weeks produced partial response in 17 of 38 patients with stage IIIB/IV NSCLC (response rate 44.7%), and the median overall survival was 11.9 months [10]. The above data suggest that conventional-dose epirubicin may be effective in NSCLC treatment.…”

Predictors of toxicity of weekly docetaxel in chemotherapy-treated non-small cell lung cancers

“…One significant predictor of treatment withdrawal was previous anthracycline use. Two prior studies in this medical center used epirubicin as part of first-line chemotherapy for advanced NSCLC [16,17]. Fourteen patients enrolled in the above two trials received cisplatin-based combination chemotherapy as their second-line therapy and weekly docetaxel as their third-line treatment.…”