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In Reply

Department of Respiratory Medicine, Osaka City University Medical School, Osaka, Japan

We agree with Malani et al regarding the good outcome in both arms of our trial and discussed the reasons for it in our article.¹ The reasons seemed to be good performance status, low rate of comorbidity, and second- or third-line treatment including gefitinib. The number of smokers in the two arms of the study, which was depicted in our Table 1,¹ was reversed with the number of nonsmokers. The number of smokers was 71 (79.8%) in docetaxel arm and 68 (74.7%) in vinorelbine arm. We made an error when making Table 1. Therefore, the smoking rate in our trial was approximately 75%.

Indeed, more than 90% of the patients in this study had good performance status of 0 or 1 and survival rates were good. But this study was a randomized trial and the aim of the study was to compare docetaxel and vinorelbine. The result was that docetaxel had a better outcome compared with vinorelbine.

In general, we did not use corticosteroids to improve the patient's quality of life in this trial. Some institutions only used corticosteroids in the premedication of docetaxel at a dose of 8 mg of dexamethasone on day 1.

We did not experience the toxicity of severe ( grade 3) nail changes and fluid retention. The median number of treatment cycles of docetaxel was four (range, one to nine cycles). Four patients received more than seven cycles of docetaxel, which was not a large number of patients. Therefore, the toxicity of nail changes and fluid retention was rare in this trial.

AUTHOR'S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

The author indicated no potential conflicts of interest.

REFERENCE

1. Kudoh S, Takeda K, Nakagawa K, et al: Phase III study of docetaxel compared with vinorelbine in elderly patients with advanced non–small-cell lung cancer: Results of West Japan Thoracic Oncology Group trial (WJTOG 9904). J Clin Oncol 24:3657-3663, 2006[Abstract/Free Full Text]

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Related Correspondence

• Docetaxel As Monotherapy in the Treatment of Advanced Non–Small-Cell Lung Cancer in Elderly Patients
  Ashok K. Malani, Rony M. Abou-Jawde, Jaswinder Singh, and Sarah A. Taylor
  JCO 2007 25: 1143-1144 [Full Text]

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