Abstract | LESSONS LEARNED: Weekly nanoparticle albumin-bound-paclitaxel (75 mg/m2) in combination with carboplatin (area under the curve 6 mg/mL/min) in elderly patients with previously untreated, advanced non-small cell lung cancer showed favorable efficacy, was well tolerated, and showed less neuropathic toxicity.This modified regimen offers potential for the treatment of elderly patients. BACKGROUND: The CA031 trial suggested weekly nanoparticle albumin-bound-paclitaxel (nab-PTX) was superior in efficacy to paclitaxel (PTX) once every 3 weeks when combined with carboplatin ( CBDCA) for advanced non-small cell lung cancer (NSCLC) patients; a subgroup analysis of elderly patients looked promising. In a multicenter phase II trial, we prospectively evaluated the efficacy and tolerability of modified CBDCA plus weekly nab-PTX for elderly patients with untreated advanced NSCLC. METHODS: Eligible patients received CBDCA (area under the curve [AUC] 6 mg/mL/min) on day 1 and nab-PTX (75 mg/m2) on days 1, 8, and 15 every 4 weeks. The primary endpoint was an overall response rate (ORR), and secondary endpoints were progression-free survival (PFS), overall survival (OS), and toxicity. RESULTS: Of 32 patients (median age of 78 years), 84% were male, 56% had stage IV NSCLC, and 56% had squamous cell carcinoma. ORR and disease control rates were 50% (95% confidence interval (CI): 33-67) and 94% (95% CI: 85-100), respectively. Median PFS and OS were 6.4 months (95% CI: 4.8-8.0) and 17.5 months (95% CI: 11.9-23.1), respectively. Grade ≥3 toxicities were neutropenia (47%), leukopenia (38%), anemia (34%), thrombocytopenia (25%), and anorexia (9%). Febrile neutropenia and treatment-related deaths were not observed. CONCLUSION: Modified CBDCA plus weekly nab-PTX demonstrated significant efficacy and acceptable toxicities in elderly patients with advanced NSCLC.
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Authors | Eisaku Miyauchi, Akira Inoue, Kazuhiro Usui, Shunichi Sugawara, Makoto Maemondo, Heisuke Saito, Yuka Fujita, Terufumi Kato, Toshiro Suzuki, Toshiyuki Harada, Hiroshi Watanabe, Taku Nakagawa, Masakazu Ichinose |
Journal | The oncologist
(Oncologist)
Vol. 22
Issue 6
Pg. 640-e59
(06 2017)
ISSN: 1549-490X [Electronic] England |
PMID | 28526722
(Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © AlphaMed Press; the data published online to support this summary is the property of the authors. |
Chemical References |
- 130-nm albumin-bound paclitaxel
- Albumins
- Carboplatin
- Paclitaxel
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Topics |
- Aged
- Aged, 80 and over
- Albumins
(administration & dosage, adverse effects)
- Antineoplastic Combined Chemotherapy Protocols
- Carboplatin
(administration & dosage, adverse effects)
- Carcinoma, Non-Small-Cell Lung
(drug therapy, pathology)
- Disease-Free Survival
- Drug-Related Side Effects and Adverse Reactions
(classification, pathology)
- Female
- Humans
- Japan
- Male
- Paclitaxel
(administration & dosage, adverse effects)
- Treatment Outcome
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