A randomised phase II study of docetaxel/oxaliplatin and docetaxel in patients with previously treated non-small cell lung cancer: An Alpe-Adria Thoracic Oncology Multidisciplinary group trial (ATOM 019)

To date, no combination regimen has proven superior to single agent chemotherapy as a second-line treatment for non-small cell lung cancer (NSCLC).
Methods: This multicenter, non-comparative randomised phase II trial evaluated the activity of docetaxel (75 mg/m2 on day 1) with oxaliplatin (70 mg/m2 on day 2) every 3 weeks in
previously treated NSCLC patients; the reference arm was single-agent docetaxel (75 mg/
m2 on day 1 every 3 weeks). It was designed as a one-stage, three-outcome phase II trial;
21 evaluable patients were required in each arm. The primary end-point was response rate;
secondary end-points were toxicity, progression free survival (PFS) and overall survival.
Results: Fifty patients were enrolled. Patient characteristics included male/female, 76/24%;
median age 62 years; ECOG PS 0/1, 36/64%; previous platinum-based chemotherapy, 98%.
Partial response was seen in 20% and 8%, stable disease in 52% and 32%, of patients treated
with docetaxel/oxaliplatin and docetaxel, respectively. Main grade 3–4 toxicities were neutropenia 56% and 64%; febrile neutropenia 4% and 8%; diarrhoea 12% and 4% for docetaxel/
oxaliplatin and docetaxel, respectively. Median PFS was 5.0 and 1.7 months, median survival 11.0 and 7.1 months, and 1-year survival 44% and 32% for docetaxel/oxaliplatin and
docetaxel, respectively.
Conclusions: The study met its pre-defined study end-point; docetaxel/oxaliplatin and more
generally platinum-containing doublets warrant further evaluation as second-line therapy
for patients with NSCLC.