Hajime Asahina1, Satoshi Oizumi2, Kei Takamura3, Toshiyuki Harada4, Masao Harada5, Hiroshi Yokouchi6, Kenya Kanazawa7, Yuka Fujita8, Tetsuya Kojima9, Fumiko Sugaya10, Hisashi Tanaka11, Ryoichi Honda12, Eiki Kikuchi13, Tomoo Ikari14, Takahiro Ogi15, Kaoruko Shimizu13, Masaru Suzuki13, Satoshi Konno13, Hirotoshi Dosaka-Akita16, Hiroshi Isobe9, Masaharu Nishimura13. 1. Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan. Electronic address: asahinah@pop.med.hokudai.ac.jp. 2. Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan. 3. Department of Respiratory Medicine, Obihiro-Kosei General Hospital, Obihiro, Japan. 4. Center for Respiratory Diseases, JCHO Hokkaido Hospital, Sapporo, Japan. 5. Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan. 6. Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan. 7. Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan. 8. Department of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, Asahikawa, Japan. 9. Department of Medical Oncology, KKR Sapporo Medical Center, Sapporo, Japan. 10. Department of Respiratory Medicine, Teine Keijinkai Hospital, Sapporo, Japan. 11. Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. 12. Department of Respiratory Medicine, Asahi Chuo Hospital, Asahi, Japan. 13. Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan. 14. Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Center for Respiratory Diseases, JCHO Hokkaido Hospital, Sapporo, Japan. 15. Department of Respiratory Medicine, Obihiro-Kosei General Hospital, Obihiro, Japan; Department of Medical Oncology, KKR Sapporo Medical Center, Sapporo, Japan. 16. Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Abstract
OBJECTIVES: Patients with concomitant advanced non-small cell lung cancer (NSCLC) and interstitial lung disease (ILD) are excluded from most clinical chemotherapy trials because of the high risk of exacerbating the latter condition. This study prospectively investigated the efficacy and safety of albumin-bound paclitaxel (nab-paclitaxel) in combination with carboplatin in patients with both advanced NSCLC and ILD. PATIENTS AND METHODS: The enrolled patients had treatment-naïve, advanced NSCLC with ILD. Patients received 100 mg/m2nab-paclitaxel weekly and carboplatin at an area under the concentration-time curve of 6 once every 3 weeks for 4-6 cycles. The primary endpoint was the overall response rate (ORR); secondary endpoints included toxicity, progression-free survival (PFS), and overall survival (OS). RESULTS: Thirty-six patients were enrolled between April 2014 and September 2017. Sixteen patients (44.4%) had adenocarcinoma, 15 (41.7%) had squamous cell carcinoma (Sq), and 5 (13.9%) had non-small cell carcinoma. The median number of cycles administered were 4 (range: 1-6). The ORR was 55.6% (95% confidence interval [CI]: 39.6-70.5). The median PFS and OS were 5.3 months (95% CI: 3.9-8.2) and 15.4 months (95% CI: 9.4-18.7), respectively. A greater proportion of patients with Sq experienced improvements than did those with non-Sq: ORRs, 66.7% (95% CI: 41.7-84.8) vs. 47.6% (95% CI: 28.3-67.6) (P = 0.254); median PFS, 8.2 months (95% CI: 4.0-10.2) vs. 4.1 months (95% CI: 3.3-5.4) (HR, 0.60 [95% CI, 0.30-1.20]; P = 0.15); and median OS, 16.8 months (95% CI: 9.8-not reached) vs. 11.9 months (95% CI: 7.3-17.4) (HR, 0.56 [95% CI, 0.24-1.28]; P = 0.17). Two patients (5.6%) experienced grade ≥2 pneumonitis and 1 patient (2.8%) died. CONCLUSION: Weekly nab-paclitaxel combined with carboplatin showed favorable efficacy with acceptable toxicity in patients with both advanced NSCLC and ILD.
OBJECTIVES:Patients with concomitant advanced non-small cell lung cancer (NSCLC) and interstitial lung disease (ILD) are excluded from most clinical chemotherapy trials because of the high risk of exacerbating the latter condition. This study prospectively investigated the efficacy and safety of albumin-bound paclitaxel (nab-paclitaxel) in combination with carboplatin in patients with both advanced NSCLC and ILD. PATIENTS AND METHODS: The enrolled patients had treatment-naïve, advanced NSCLC with ILD. Patients received 100 mg/m2nab-paclitaxel weekly and carboplatin at an area under the concentration-time curve of 6 once every 3 weeks for 4-6 cycles. The primary endpoint was the overall response rate (ORR); secondary endpoints included toxicity, progression-free survival (PFS), and overall survival (OS). RESULTS: Thirty-six patients were enrolled between April 2014 and September 2017. Sixteen patients (44.4%) had adenocarcinoma, 15 (41.7%) had squamous cell carcinoma (Sq), and 5 (13.9%) had non-small cell carcinoma. The median number of cycles administered were 4 (range: 1-6). The ORR was 55.6% (95% confidence interval [CI]: 39.6-70.5). The median PFS and OS were 5.3 months (95% CI: 3.9-8.2) and 15.4 months (95% CI: 9.4-18.7), respectively. A greater proportion of patients with Sq experienced improvements than did those with non-Sq: ORRs, 66.7% (95% CI: 41.7-84.8) vs. 47.6% (95% CI: 28.3-67.6) (P = 0.254); median PFS, 8.2 months (95% CI: 4.0-10.2) vs. 4.1 months (95% CI: 3.3-5.4) (HR, 0.60 [95% CI, 0.30-1.20]; P = 0.15); and median OS, 16.8 months (95% CI: 9.8-not reached) vs. 11.9 months (95% CI: 7.3-17.4) (HR, 0.56 [95% CI, 0.24-1.28]; P = 0.17). Two patients (5.6%) experienced grade ≥2 pneumonitis and 1 patient (2.8%) died. CONCLUSION: Weekly nab-paclitaxel combined with carboplatin showed favorable efficacy with acceptable toxicity in patients with both advanced NSCLC and ILD.
Authors: Xie Xiaohong; Wang Liqiang; Li Na; Lin Xinqing; Qin Yinyin; Liu Ming; Ouyang Ming; Han Qian; Luo Qun; Li Shiyue; Li Chunyan; Wang Xiaoqian; Yang Shuanying; Huang Wei; Liu Mei; Wang Ping; Zhou Chengzhi Journal: Front Mol Biosci Date: 2021-03-31