docetaxel + cisplatin + irinotecan

A three-drug cytotoxic chemotherapy regimen combining the taxane docetaxel, the platinum agent cisplatin, and the topoisomerase I inhibitor irinotecan, investigated as a first-line treatment for advanced non-small cell lung cancer. Mechanistically, docetaxel stabilizes microtubules and inhibits depolymerization, cisplatin forms intrastrand and interstrand DNA crosslinks leading to apoptosis, and irinotecan (via its active metabolite SN-38) inhibits topoisomerase I causing DNA damage during replication. In a phase I/II study in stage IIIB/IV NSCLC, the recommended dose was docetaxel 60 mg/m2 (day 1), cisplatin 60 mg/m2 (day 1), and irinotecan 60 mg/m2 (day 2) every 3 weeks, yielding a 57.1% objective response rate and median survival of 17 months, with principal grade 3/4 toxicities of neutropenia, febrile neutropenia, diarrhea, and nausea/vomiting[4]. Related randomized phase II studies established activity of the docetaxel/cisplatin doublet and the docetaxel/irinotecan doublet in advanced NSCLC, supporting exploration of the triplet[1]. Sequential regimens using irinotecan/cisplatin followed by docetaxel have also shown feasibility with prolonged progression-free survival in treatment-naïve advanced NSCLC[2].

Brand names

TaxotereCamptosarPlatinol

Other names

DCI triplet