Nab-Paclitaxel vs Solvent-Based Paclitaxel Reduces Neuropathy in Patients with NSCLC
Mark A. Socinski, MD, of the University of Pittsburgh Medical Center, Pittsburgh, PA, and colleagues reported patient-assessed neuropathy and taxane-associated symptoms from a phase 3 trial of nab-paclitaxel plus carboplatin vs solvent-based paclitaxel plus carboplatin in patients with untreated stage IIIB/IV non–small-cell lung cancer.
Patients were randomly assigned to carboplatin AUC6 on day 1 and either nab-paclitaxel 100mg/m2 on days 1, 8, and 15 (n=521) or solvent-based paclitaxel 200mg/m2 on day 1 (n=531) every 21 days. The investigators assessed mean change from baseline to day 1 of each of 8 cycles for each subscale of the Functional Assessment of Cancer Therapy (FACT)-Taxane v4.0.
A total of 98% of patients completed FACT-Taxane at baseline; scores for neuropathy and pain were well balanced. During follow-up or at treatment completion, 94% completed FACT-Taxane. They found a significant treatment effect favoring nab-paclitaxel for patient-reported peripheral neuropathy (P<0.001), neuropathic pain in the hands and feet (P<0.001) and hearing loss (P=0.002) through 8 cycles of treatment and at the final evaluation.
Dr. Socinski reported that outcomes for neuropathy were consistent with physician assessment.
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