A phase I/II trial of weekly docetaxel and gefitinib in elderly patients with stage IIIB/IV non-small cell lung cancer

Stinchcombe, Thomas E.; Bůžková, Petra; Choksi, J. K.; Taylor, Madeline; Bakri, Kamal; Gillenwater, Heidi H.; Tynan, Maureen; Mears, A.; Jones, Paul; Socinski, Mark A.

doi:10.1016/j.lungcan.2006.03.002

Cited by 9 publications

(7 citation statements)

References 30 publications

(41 reference statements)

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“…However, in studies of Stinchcombe et al in a phase I/II trial of weekly docetaxel and gefitinib in these patients with stage IIIB/IV NSCLC, unexpected toxicity was observed 165, 166.…”

Section: Molecular Pathways and Targeted Therapiesmentioning

confidence: 92%

Molecular Targeted Drugs and Biomarkers in NSCLC, the Evolving Role of Individualized Therapy

Domvri¹,

Zarogoulidis²,

Darwiche³

et al. 2013

J. Cancer

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Lung cancer first line treatment has been directed from the non-specific cytotoxic doublet chemotherapy to the molecular targeted. The major limitation of the targeted therapies still remains the small number of patients positive to gene mutations. Furthermore, the differentiation between second line and maintenance therapy has not been fully clarified and differs in the clinical practice between cancer centers. The authors present a segregation between maintenance treatment and second line and present a possible definition for the term “maintenance” treatment. In addition, cancer cell evolution induces mutations and therefore either targeted therapies or non-specific chemotherapy drugs in many patients become ineffective. In the present work pathways such as epidermal growth factor, anaplastic lymphoma kinase, met proto-oncogene and PI3K are extensively presented and correlated with current chemotherapy treatment. Future, perspectives for targeted treatment are presented based on the current publications and ongoing clinical trials.

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“…However, in studies of Stinchcombe et al in a phase I/II trial of weekly docetaxel and gefitinib in these patients with stage IIIB/IV NSCLC, unexpected toxicity was observed 165, 166.…”

Section: Molecular Pathways and Targeted Therapiesmentioning

confidence: 92%

Molecular Targeted Drugs and Biomarkers in NSCLC, the Evolving Role of Individualized Therapy

Domvri¹,

Zarogoulidis²,

Darwiche³

et al. 2013

J. Cancer

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show abstract

“…Gefitinib addition to chemotherapy has been tested. Stinchcombe et al [63] combined weekly docetaxel plus daily oral gefitinib: RR 31%, MST 6.5 mo, 1-year survival 27%. The schedule resulted in excessive toxicity for elderly patients [63] .…”

Section: Egfr Tyrosine Kinase Inhibitorsmentioning

confidence: 99%

“…Stinchcombe et al [63] combined weekly docetaxel plus daily oral gefitinib: RR 31%, MST 6.5 mo, 1-year survival 27%. The schedule resulted in excessive toxicity for elderly patients [63] . Bepler et al [64] added daily gefitinib to three-weekly docetaxel: RR 38%, SD 24%, MST 12.4 mo, and 1-year survival of 60%.…”

Section: Egfr Tyrosine Kinase Inhibitorsmentioning

confidence: 99%

Advanced non-small cell lung cancer in elderly patients: A review

Buffoni¹

2015

WJR

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Over 50% of patients diagnosed with non-smallcell lung cancer (NSCLC) are 65 years old while 30% exceed 70 years old. Comparing elderly patients to their younger counterpart they poorly tolerate chemotherapy due to progressive reduction of organ function and age-related co-existing pathologies. Due to this reason elderly are usually excluded from platinum-based chemotherapy, which still represent the standard of care for advanced NSCLC. In every-day practice, single-agent schedule with a third-generation drug is the recommended option for elderly patients with advanced NSCLC. A modest increase in toxicity for elderly patients has been demonstrated by subgroup analyses concluding for platinum-based combination chemotherapy being similar in young patients and fit elderly. Even though the cited evidence, feasibility of chemotherapy based on platinum remains an open question. Prospective randomised trials are warranted in order to change guide lines and give the clinicians a new therapeutic option. Recent emerging role of molecular target in selecting patients for new targeted therapies suggest dedicated trials for elderly patients. The same is for more accurate evaluation of elderly patients with increasing evidence for a comprehensive geriatric assessment as a valid tool for customized treatment in NSCLC elderly patients. Suitable evidences for the treatment of elderly patients affected by advanced NSCLC together with more appropriate and validated tools for patients selection are reviewed along the manuscript.

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“…Docetaxel also appears to be suitable for administration in combination with a molecular targeted agent for the treatment of older NSCLC patients. Although a phase I/II study evaluating a combination of weekly docetaxel plus daily gefitinib was terminated early because of unexpected toxicities [20], findings from a phase II study investigating a combination of 3-weekly docetaxel and daily gefitinib in older patients with NSCLC were more promising [24]. An RR of 40% with median survival duration of 9.6 months was reported, with a significantly longer survival time in women than in men (22.8 versus 4.8 months).…”

Section: Phase II Studiesmentioning

confidence: 99%

“…Although these combinations have not been evaluated in age-specific studies, the results from other studies have implications for the treatment of the elderly. The evaluation of the docetaxel-gefitinib combination was described above [20]. Another phase II trial in older patients has evaluated the combination of celecoxib, a cyclooxygenase-2 inhibitor, with docetaxel [59].…”

Section: Targeted Agents In Combination With Chemotherapy For Older Pmentioning

confidence: 99%

The Role of the Taxanes in the Treatment of Older Patients with Advanced Stage Non-Small Cell Lung Cancer

Ramalingam

Khuri

2009

The Oncologist

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The treatment of older patients with advanced nonsmall cell lung cancer (NSCLC) represents a considerable challenge for physicians. A patient's suitability for chemotherapy is frequently based solely on chronologic age; as a consequence, older patients with NSCLC are less likely to receive standard chemotherapy than younger patients. Although age-related factors, such as comorbid illness, should be taken into consideration when assessing a patient's suitability for treatment, fit and functionally independent older patients should be considered candidates for standard chemotherapy. The taxanes are widely used in the treatment of advancedstage NSCLC and are well tolerated in older patients. The efficacy of both paclitaxel and docetaxel has been studied in older patients and appears to be comparable with that seen in younger patients either as monotherapy or in combination with a platinum compound as first-line therapy. In addition to the available evidence, prospective evaluation of novel agents in elderlyspecific or -enriched studies is necessary to guide the treatment of older patients with NSCLC. The Oncologist

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A phase I/II trial of weekly docetaxel and gefitinib in elderly patients with stage IIIB/IV non-small cell lung cancer

Cited by 9 publications

References 30 publications

Molecular Targeted Drugs and Biomarkers in NSCLC, the Evolving Role of Individualized Therapy

Molecular Targeted Drugs and Biomarkers in NSCLC, the Evolving Role of Individualized Therapy

Advanced non-small cell lung cancer in elderly patients: A review

The Role of the Taxanes in the Treatment of Older Patients with Advanced Stage Non-Small Cell Lung Cancer

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