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

Abstract

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. 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. 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. 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.