Single-agent docetaxel in patients with refractory non-small-cell lung cancer

There are few options available for the patient with advanced non- small-cell lung cancer in whom first-line chemotherapy has failed. Docetaxel (Taxotere), a semisynthetic taxoid, is one of the few drugs that has been systematically investigated as a second-line option for patients with advanced non-small-cell lung cancer. Four phase II studies have now demonstrated that 100 mg/m² of docetaxel, administered over 1 hour once every 3 weeks, offers some activity against platinum-resistant or platinum- refractory non-small-cell lung cancer. Partial responses have ranged from 14% to 22%, and the median survival duration ranges from 30 to 42 weeks. A comparison of survival data from a phase II trial with historical controls suggests that there also may be a clinically meaningful survival advantage afforded by docetaxel, 100 mg/m², in the second-line setting, with improvement in median survival from 16 to 42 weeks, and 1-year survival improvement from 16% to 41%. Two large, randomized trials are currently ongoing to better define the role of docetaxel in the second-line setting.