Abstract

BackgroundFew studies have investigated the clinical efficacy of third- and later-line of chemotherapy after standard chemotherapy for previously treated advanced non-small cell lung cancer (NSCLC). We prospectively evaluated the efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) following standard chemotherapies for previously treated advanced NSCLC.MethodsThe eligible patients having adequate organ functions with performance status 0–2 were enrolled after completing standard chemotherapy. They received weekly nab-paclitaxel 100 mg/m2 intravenously on days 1, 8, and 15 every 3 weeks. The primary end point was objective response rate (ORR). Median progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were evaluated as secondary end points.ResultsThis trial was discontinued because of late accrual. Twenty two patients were enrolled from April 2013 and February 2019. The total ORR was 22.7% [95% CI 7.8–45.4] and disease control rate (DCR) was 81.8% [95% CI 59.7–94.8]. Median PFS was 3.4 months [95% CI 2.3–4.1] and median OS was 7.4 months [95% CI 4.2–10.7]. Median follow-up interval was 6.7 months hematological AEs of Grade 3/4 included anemia (18%), leukopenia (18%), and neutropenia (32%), while the most frequent nonhematological AEs were fatigue (50%) and peripheral neuropathy (36.4%). Severe AEs related to treatment were observed in only one patient.ConclusionNab-paclitaxel may be a safe and effective later-line chemotherapeutic option for previously treated advanced NSCLC after standard of chemotherapies based on other trials.

Highlights

  • Non-small cell lung cancer (NSCLC) is one of the most common cancers and prognosis remains poor [1]

  • Immune checkpoint inhibitors (ICIs) resulted in longer median overall survival (OS) for naive advanced non-small cell lung cancer (NSCLC) compared to platinum doublet therapy alone [4,5,6], and this combination therapy is considered standard for NSCLC without targetable genetic alterations

  • Combination therapy with docetaxel and ramucirumab resulted in longer progression-free survival (PFS) in patients with platinum doublet-refractory NSCLC [12]

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Summary

Introduction

Non-small cell lung cancer (NSCLC) is one of the most common cancers and prognosis remains poor [1]. ICI resulted in longer median overall survival (OS) for naive advanced NSCLC compared to platinum doublet therapy alone [4,5,6], and this combination therapy is considered standard for NSCLC without targetable genetic alterations. Combination therapy with docetaxel and ramucirumab resulted in longer progression-free survival (PFS) in patients with platinum doublet-refractory NSCLC [12]. Several phase III trials reported better efficacy of ICI treatment for platinum doublet-refractory advanced NSCLC compared to docetaxel [13,14,15]. Conclusion Nab-paclitaxel may be a safe and effective later-line chemotherapeutic option for previously treated advanced NSCLC after standard of chemotherapies based on other trials

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