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A Pilot Study of Docetaxel and Trofosfamide as Second-Line ‘Metronomic’ Chemotherapy in the Treatment of Metastatic Non-Small Cell Lung Cancer (NSCLC)Görn M.a · Habermann C.R.b · Anige M.a · Thöm I.a · Schuch G.a · Andritzky B.a · Brandl S.a · Burkholder I.c · Edler L.c · Hossfeld D.K.a · Bokemeyer C.a · Laack E.a
a Department of Oncology, Hematology, Bone Marrow Transplantation with the Section of Pneumology, bDepartment for Interventional and Diagnostic Radiology, University Hospital Hamburg-Eppendorf, Hamburg, c Department of Biostatistics, German Cancer Research Center, Heidelberg, Germany
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.
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