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Y. Matsumura

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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): Y. Matsumura

      • Abstract
      • Slides

      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.

      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.

      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.

      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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