Nab-Paclitaxel + Carboplatin Ups PFS in Elderly Advanced NSCLC Patients

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(CHICAGO, IL) – Weekly doses of albumin-bound paclitaxel particles lead to longer survival and are better tolerated than solvent-based paclitaxel in patients with advanced non-small cell lung cancer (NSCLC), according to the results of a phase 3 study presented at the 2012 American Association of Clinical Oncology Annual Meeting.

Elderly patients (≥70 years) with advanced NSCLC are generally undertreated, with only approximately 30% receiving systemic therapy, said  lead author Mark A. Socinski, MD, of the University of Pittsburgh Medical Center Cancer Pavilion, Pittsburgh, PA. He added that better, more tolerable therapeutic options are needed for this patient population. This study provided an analysis of efficacy and safety of a phase 3 trial comparing nab-paclitaxel (nab-P, albumin-bound paclitaxel particles) plus carboplatin (C) to solvent-based paclitaxel (sb-P) plus carboplatin in patients with advanced NSCLC that are ≥70 and <70 years of age.

In both age cohorts, overall response rate was higher in the nab-P/C vs the sb-P/C arm (≥70: 34% vs 24%, P=0.196; <70: 32% vs 25%, P=0.013). In patients ≥70 years old, PFS trended in favor of nab-P/C (median 8.0 vs 6.8 months, HR=0.687, P=0.134) and OS was significantly improved (median 19.9 vs 10.4 months, HR=0.583, P=0.009). In contrast, differences were not found for PFS (6.0 vs 5.8 median months, HR=0.903, P=0.256) or OS (11.4 vs 11.3 median months, HR=0.999, P=0.988) among patients <70 years old.

Adverse events were similar in patients ≥70 years old vs the entire study population, with less grade 3/4 neutropenia (P<0.05) and neuropathy (P<0.05), but increased thrombocytopenia (P=NS) and anemia (P<0.05) in the nab-P/C vs sb-P/C arms.

Dr. Socinski and colleagues concluded that, in elderly patients with advanced NSCLC, nab-P/C as first-line therapy was well tolerated and led to improved overall response rate and progression-free survival, with significantly longer overall survival vs solvent-based paclitaxel.

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