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P1.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 212)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
P1.03-015 - Safety and Effectiveness of Chemo-Radiotherapy with Weekly Nab Paclitaxel plus Carboplatin in Locally Advanced Non-Small Cell Lung Cancer (ID 2956)
09:30 - 17:00 | Author(s): T. Hasegawa
Combination therapy of carboplatin (CBDCA) and nab-PTX is a useful choice for first-line therapy of patients with advanced non-small cell lung cancer (NSCLC). The efficacy and safety of weekly albumin-bound paclitaxel (nab-PTX) and carboplatin (CBDCA) with concurrent radiotherapy for unresectable locally advanced non-small cell lung cancer was evaluated as a multicenter phase II study of Gifu thoracic oncology group.
Patients with stage III NSCLC and an Eastern Cooperative Oncology Group performance status of 0 or 1 were eligible. Concurrent chemoradiotherapy consisted of weekly administration of nab-PTX (40 mg/m) plus CBDCA (area under the plasma concentration time curve (AUC) 2) and thoracic radiotherapy (60 Gy/30 fractions) for a total of 6 weeks. The primary tumor and involved nodal disease received 60 Gy in 2-Gy fractions over 6 weeks. A three dimensional treatment planning system was used in every institute. After concurrent chemoradiotherapy, patients received an additional two cycles of consolidation phase chemotherapy that consisted of 4-week cycles of nab-PTX (100 mg/m on days 1, 8, and 15)/CBDCA (AUC 5 mg/ml/min on day 1). Response was evaluated in accordance with the RECIST. Progression-free and overall survival were estimated using the Kaplan Meier method. Toxicity was graded using the National Cancer Institute Common Terminology Criteria for Adverse Events.
The study became way canceled for serious adverse events, when the 10 cases were enrolled in this trial between September 2013 and January 2014 from 3 institutes. Patient characteristics are summarized as follow. The median age was 73 years. The ECOG performance status was 0 for 30% of patients and 1 for 70% of patients. Of these patients, 5 cases had squamous cell carcinoma and 5 cases had adenocarcinoma. The overall response rate was 40.0% and the median progression-free survival was 6.7 months. total of 7 patients were unable to complete the consolidation phase chemotherapy because of toxicities (pneumonitis, lung infection, or heart failure), poor PS, or patient preference. The most common grade 3/4 hematological toxicity was leukopenia (8 patients, 80%). Other grade 3/4 hematological toxicities were neutropenia (5 patients, 50%) and anemia (1 patient, 10%). Other grade 3 or worse severe toxicities were anorexia (3 patients, 30%), nausea (2 patients, 20%), diarrhea (1 patient, 10%), pneumonitis (2 patients, 20%), heart failure (2 patients, 20%), and lung infection (1 patient, 10%). Treatment-related death occurred in two patients. Grade 2 or worse severe pneumonitis was observed in all 3 patients that had volume of lung receiving at least 20 Gy (V20) >30%.
The results of this study indicate that no further investigation is warranted into nab-PTX and CBDCA with concurrent thoracic radiation using three dimensional treatment planning system for stage III NSCLC with V20 >30% due to severe toxicity.
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