A Pilot Study of Docetaxel and Trofosfamide as Second-Line ‘Metronomic’ Chemotherapy in the Treatment of Metastatic Non-Small Cell Lung Cancer (NSCLC)

Abstract

Background: The aim of this pilot study was to evaluate the efficacy and safety of a chemotherapy containing docetaxel and oral trofosfamide as a ‘metronomic’ secondline treatment of patients with metastatic non-small cell lung cancer (NSCLC). Patients and Methods: 21 patients with stage IV disease NSCLC who had progressed under first-line chemotherapy were enrolled. Previous chemotherapy was platinum-based in 15 patients (71.4%), whereas 6 patients (28.6%) had received platinum-free combination chemotherapy. Patients received docetaxel 25 mg/m² on days 1, 8, and 15 every 4 weeks plus trofosfamide 50 mg per day. Results: A total of 62 chemotherapy cycles were administered. The median number of cycles per patient was 3. The overall response rate to chemotherapy was 19%, median overall survival was 6.9 months, the median progression-free survival 2.9 months, the 1-year survival rate 28.6%, and the 2-year survival rate 7.1%. No grade IV toxicity was observed. Conclusions: Our results suggest that the combination of docetaxel and trofosfamide in a metronomic schedule is active and well tolerable as second-line therapy in patients with metastatic NSCLC. The concept of metronomic chemotherapy promises to be a valuable addition to the existing treatment options in NSCLC and warrants further investigation in phase III studies.

Combination Effects of Docetaxel and Doxorubicin in Hormone-Refractory Prostate Cancer Cells

“…Multiple drugs can compete with each other for the same transporter, molecular target, or have conflicting effects on the cell cycle. Studies suggest that cancer cells are sensitive to multiple drugs at a certain drug mixing ratio, and that that optimal mixing ratio must be retained in tumor tissues to achieve the maximal drug combination effect [8–12]. Therefore, it is critical to identify the optimal combination settings and study the cellular response in detail.…”

Nail alterations as a surrogate marker for the efficacy of low-dose metronomic chemotherapy

“…An alternative approach to systemic chemotherapy is low-dose metronomic (LDM) chemotherapy, which is focused on the treatment of various neoplastic diseases (4–6). LDM chemotherapy involves frequent administration of a cytotoxic drug in a low dose to exert an alternative antitumor effect, in addition to a direct cytotoxic effect.…”

Metronomic Chemotherapy: A Systematic Review of the Literature and Clinical Experience

“…Goern et al used 25 mg/m 2 weekly docetaxel and 50 mg daily trofosfamide in 62 stage IV NSLC patients. Overall response was 19%; median OS was 9.6 months; with PFS of 2.9 months [180]. Same authors studied efficacy of cisplatin 30 mg/m 2 days 1-3, with bevacizumab 5 mg/kg in day 3 and oral etoposide in days 1-15 repeating every 3 weeks (mPEBev regimen) in 45 stage III/IV non-small cell lung cancer.…”