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Phase II Trial of Paclitaxel and Carboplatin in Metastatic Small-Cell Lung Cancer: A Groupe Français de Pneumo-Cancérologie Study

From the Service d’Oncologie Respiratoire and Pharmacie, Hôpital Sainte-Marguerite, Marseille; Service d’Oncologie Thoracique, Hôpital Morvan, Brest; and Services de Pneumologie, Hôpital Bois-Guillaume, Bois Guillaume, Hôpital de Pontchaillou, Rennes, Hôpital Gaston Doumergues, Nîmes, Hôpital Saint-Faron, Meaux, Hôpital Maison Blanche, Reims, Centre Hospitalier Général, Aix en Provence, and Centre Hospitalier Général, La Seyne sur Mer, France.

Address reprint requests to Thomas Pascal, MD, Service d’Oncologie Respiratoire, Département des Maladies Respiratoires, Hôpital Ste-Marguerite, 270 Bd Ste-Marguerite, 13 009 Marseille, France; email: pnthomas{at}ap-hm.fr

PURPOSE: To evaluate the efficacy and safety of paclitaxel and carboplatin in the treatment of previously untreated patients with metastatic small-cell lung cancer (SCLC).

PATIENTS AND METHODS: Eligible patients were aged 18 to 75 years with an Eastern Cooperative Oncology Group (ECOG) score 2 and life expectancy 12 weeks. Paclitaxel (200 mg/m²) was infused over 3 hours, before carboplatin (area under the curve [AUC] 6; Calvert formula) infused over 1 hour, once every 3 weeks for six cycles maximum. Prednisolone, dexchlorpheniramine, and ranitidine were standard premedication. Response to treatment was assessed every two cycles, and nonresponding patients were withdrawn from the trial to receive standard chemotherapy.

RESULTS: Of the 50 patients entering the study, 48 and 46 patients were assessable for toxicity and response, respectively. The overall response rate was 65%, with complete responses in three patients. Five patients had stable disease (11%) and 11 patients experienced progressive disease (24%). Median survival was 38 weeks, and median duration of response was 20 weeks. One-year survival was 22.5%. For a total of 232 cycles, grade 3 and 4 toxicity was 33% for neutropenia, 3.5% for thrombocytopenia, and 4% for anemia. Four patients had neutropenic fever (one toxic death). Nonhematologic toxicity was mainly grade 1 and 2 paresthesia (21% of patients); grade 3 myalgia/arthralgia was observed in 6.5% of patients.

CONCLUSION: First-line chemotherapy with paclitaxel and carboplatin in metastatic SCLC achieved a response rate and survival similar to standard regimens. With 1-day administration and a tolerable toxicity profile, this combination merits further investigation.

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