Preliminary analysis of paclitaxel, carboplatin, and concurrent radiation in the treatment of patients with advanced non-small cell lung cancer

Previously untreated patients with stage IIIA or IIIB non-small cell lung cancer were entered into a phase II study to evaluate the activity and toxicity of combined peclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) and carboplatin with concurrent radiation. Patients received peclitaxel 50 mg/m²/wk as a 1-hour infusion and carboplatin area under the concentration-time curve of 2 weekly for 7 weeks, followed by radiation to the primary tumor and regional lymph nodes (44 Gy) and, later, by a boost to the tumor (22 Gy). In addition, patients received two additional cycles of paclitaxel 200 mg/m² and carboplatin (area under the concentration-time curve 6) every 3 weeks. From March 1995 to February 1996, 23 patients have entered the study. The overall response rate was 82% and the major toxicity was esophagitis. Nine patients (45%) experienced grade 3 or 4 esophagitis at the end of the concurrent phase; seven of the nine patients recovered within 2 weeks and received an additional two cycles of combined paclitaxel/carboplatin. Only one patient (4%) had grade 4 pneumonitis, and again, the patient recovered within 2 weeks and received posterior chemotherapy. With a high response rate and acceptable toxicity, therapy with peclitaxel, carboplatin, and radiation is a promising treatment for patients with locally advanced non-small cell lung cancer.