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Albumin-bound paclitaxel improves treatment of advanced lung cancer

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Patients with advanced non-small-cell lung cancer have higher response rates to a regimen that includes an albumin-bound formulation of paclitaxel (nab-paclitaxel) than solvent-based paclitaxel, an international team reports in the Journal of Clinical Oncology online April 30.

In particular, patients with squamous cell histology responded “remarkably well” to the nab-paclitaxel regimen, the authors note. “This is particularly intriguing because improved therapeutic options for the subset of patients with squamous histology are needed,” they point out.

Dr. Mark A. Socinski, at the University of Pittsburgh Medical Center, Pennsylvania, and colleagues explain that preclinical studies of the albumin-bound formulation of paclitaxel (Abraxane; Celgene) indicated that it reaches tumor microenvironments more efficiently than solvent-based paclitaxel, with preferential uptake by cancer cells.

The current study compared the efficacy and safety of carboplatin every 3 weeks plus weekly nab-paclitaxel or solvent-based paclitaxel in 1052 untreated patients with stage IIIB to IV NSCLC.

The overall response rate was 33% in the nab-paclitaxel/carboplatin (nab-PC) arm versus 25% in the solvent-based paclitaxel/carboplatin (sb-PC) group, the team reports. This translated to a response rate ratio of 1.313 (p=0.005).

In the subset of patients with squamous histology, the nab-paclitaxel regimen was even more effective (overall response rate 41% v 24%; response rate ratio, 1.680; p

There was an improvement in progression-free survival with nab-PC compared to sb-PC (6.3 vs 5.8 months) and in overall survival (12.1 months vs 11.2 months), although these differences were not statistically significant.

Furthermore, rates of grade 3 or higher neuropathy were less with nab-PC compared to sb-PC, Dr. Socinski and colleagues found.

“Taken together,” they conclude, “the nab-PC regimen has a favorable risk-benefit profile compared with that of sb-PC as first-line therapy for all patients with NSCLC.”

SOURCE:

Weekly nab-Paclitaxel in Combination With Carboplatin Versus Solvent-Based Paclitaxel Plus Carboplatin as First-Line Therapy in Patients With Advanced Non–Small-Cell Lung Cancer: Final Results of a Phase III Trial

J Clin Oncol 2012;30.