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H. Takagi



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    P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P1.01-051 - Efficiency of Nab-Paclitaxel as a Late Phase Chemotherapy for NSCLC (ID 238)

      09:30 - 17:00  |  Author(s): H. Takagi

      • Abstract
      • Slides

      Background:
      Nanoparticle albumin-bound (nab) paclitaxel is a biologically interactive nanoparticle, combining albumin with paclitaxel and has a better toxicity profile compared to solvent-based paclitaxel. Recently some studies are reported which show the efficacy of nab-paclitaxel as first line chemotherapy for non-small cell lung cancer (NSCLC), but rarely reported until today to elucidate the efficacy of nab-paclitaxel with carboplatin (CBDCA) as second or later phase chemotherapy for NSCLC. We here evaluate the efficiency and feasibility of nab-paclitaxel plus CBDCA as second or later phase chemotherapy in patients with recurrent or advanced NSCLC in this study.

      Methods:
      Twenty-five patients with recurrence after radical surgery for NSCLC and unresectable stage IIIB/IV NSCLC who had received previous chemotherapies were treated with nab-paclitaxel 70mg/m[2] intravenously on day1, 8, and 15 with CBDCA area under the concentration-time curve of 4 (AUC4) intravenously on day1, every 28 days. Progression-free (PFS) and overall survival (OS) rates were calculated by means of Kaplan-Meier analysis and statistical significance between the groups was analyzed by using log-rank tests. Disease control rates and toxicity were also evaluated. Disease response in all of the patients was monitored after two cycles of chemotherapy.

      Results:
      Of 25 patients who participated in this study, 9 were recurrent and 16 were advanced case. 13 were adenocarcinoma, 11 were squamous cell carcinoma and 1 was large cell carcinoma. 13 were performed as second line chemotherapy, 6 were as third line and 6 were forth or later line. EGFR mutation status was positive in 5 patients (20.0%) and they all received EGFR-TKI in their serial chemotherapy. One achieved complete response (CR), 7 reached a stage of partial responses (PR), 10 maintained stable disease (SD) and 7 suffered progressive diseases (PD). The overall response rate (ORR) was 32.0% and disease control rate (DCR) was 72.0%. The median PFS was 4.8 months and median OS was 29.0 months. Common treatment related adverse events were myelosuppression, baldness, peripheral neuropathy and gastrointestinal symptoms, most of which were grade 1 to 2. Grade 3-4 neutropenia was present in 6 patients (24.0%), thrombocytopenia and anemia in 2 patients (8.0%), respectively. No patients experienced grade 3-4 neuropathy. The need of a dose reduction was 26.9% because of toxicity, but there were no adverse effects of grade 5.

      Conclusion:
      Nab-paclitaxel plus CBDCA as second or later phase chemotherapy offers a small but significant survival benefits for the patients with recurrent and advanced NSCLC, and its adverse effects are tolerable. Further studies including prospective studies of this regimen are required.

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