Triplet Chemotherapy with Docetaxel, Gemcitabine and Liposomal Doxorubicin, Supported with Subcutaneous Amifostine and Hemopoietic Growth Factors, in Advanced Non-small Cell Lung Cancer

Abstract

The activity of a triplet of chemotherapeutic drugs, namely docetaxel, gemcitabine and liposomal doxorubicin, was investigated in patients with advanced non-small cell lung cancer. The regimen was supported with amifostine cytoprotection (1000mg injected subcutaneously) and hemopoietic growth factors (rhuG-CSF and rhuEPO) in an attempt to minimize the substantial toxicity reported in previous studies investigating docetaxel/gemcitabine chemotherapy. Twenty chemotherapy- naïve patients with advanced non-small cell lung cancer (NSCLC) (18 with stage IV and 2 with stage IIIb) were recruited. None of the patients presented with grade 3-4 hematological or non-hematological toxicity. Palmar-plantar erythrodysesthesia grade 2 was noted in 6/20 (30%), mucositis/oesophagitis grade 2 in 3/20 (15%) and mild alopecia in 6/20 (30%) patients. No case of interstitial pneumonia was noted. The overall response rate (complete and partial) in 18 evaluable patients was 33% (6/18), with 1/18 (5%) patients achieving complete response. The median survival was 11 months. The efficacy of the regimen was as high as the one reported in gemcitabine/docetaxel studies, but the toxicity was remarkably lower. Amifostine may have contributed to the better tolerance profile observed.