Efficacy and Safety of Nab-Paclitaxel as Second-line Chemotherapy for Locally Advanced and Metastatic Non-small Cell Lung Cancer

Anticancer Res. 2017 Aug;37(8):4687-4691. doi: 10.21873/anticanres.11873.

Abstract

Aim: To investigate the efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) for locally advanced or metastatic non-small cell lung cancer (NSCLC) as second-line chemotherapy.

Patients and methods: We retrospectively reviewed the treatment of 34 patients with advanced NSCLC whose first-line treatment had failed. These patients received nab-paclitaxel 260 mg/m2 on day 1 and day 8 of a 21-day cycle from July 2014 to February 2016. One cycle of treatment lasted 3 weeks and all patients completed more than two cycles. All patients were assessed for adverse events related to treatment.

Results: No patient achieved complete response (CR); 12 patients reached partial response (PR), 12 patients achieved stable disease (SD) and 10 patients progressive disease (PD). The overall response rate (ORR) was 35.3% and the disease control rate (DCR) 70.6 %. There was no significant difference in either ORR or DCR within the subgroups. The median progression-free survival (PFS) was 5.7 months (95% confidence interval (CI)=3.8-7.6) and the median overall survival (OS) was 9 months (95% CI=8.3-9.7). There was no statistical difference in OS (p=0.066), but subgroup analysis showed that patients with squamous carcinoma benefited more in PFS (the median PFS of squamous carcinoma vs. adenocarcinoma was 7.3 months vs. 5 months, p=0.001). Major adverse events included myelosuppression, gastrointestinal response, baldness, myalgia and neurotoxicity. Hypersensitivity reactions were not reported.

Conclusion: Nab-paclitaxel is an effective chemotherapy for locally advanced and metastatic NSCLC as treatment and has a superior application prospect for squamous NSCLC. Toxicity is generally mild and manageable.

Keywords: NSCLC; chemotherapy; nab-paclitaxel; second-line.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Albumins / administration & dosage
  • Albumins / adverse effects
  • Albumins / therapeutic use*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Combined Modality Therapy
  • Female
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Paclitaxel / administration & dosage
  • Paclitaxel / adverse effects
  • Paclitaxel / therapeutic use*
  • Retreatment
  • Risk Factors
  • Survival Analysis
  • Treatment Outcome

Substances

  • 130-nm albumin-bound paclitaxel
  • Albumins
  • Paclitaxel