Drug Combination May Provide Option To Patients With NSCLC Ineligible For Bevacizumab
A combination of nab-paclitaxel and carboplatin for the treatment of non-small cell lung cancer may be a promising option for patients ineligible for treatment with bevacizumab, according to data presented at the AACR Annual Meeting 2012, held here March 31 – April 4.
“The combination of carboplatin and nab-paclitaxel demonstrates promising efficacy with tolerable toxicity in patients with non-small cell lung cancer (NSCLC) ineligible for therapy with bevacizumab,” said Gregory A. Otterson, M.D., professor of internal medicine, co-director of the thoracic oncology program and associate director of the hematology and medical oncology fellowship program at The Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus, Ohio.
Otterson and colleagues evaluated the drug combination in 63 patients with advanced NSCLC. Seventy-six percent of patients had squamous histology, making them ineligible for bevacizumab. Other contraindications for bevacizumab among this patient population included hemoptysis, thrombosis and therapeutic anticoagulation. Researchers assigned patients to 300 mg/m2/AUC6, which was later adjusted to 260 mg/m2/AUC6 due to excess neuropathy, every 21 days.
Researchers found an overall response rate of 41 percent among 53 patients available for evaluation. An additional 39 percent of patients had stable disease for at least six weeks. Disease progressed in 19 percent of patients.
“We have been surprised at the durability of response with some patients not requiring further treatment for at least six months,” Otterson said.
More than 10 percent of patients had grade 3 to 4 toxicities, including hematologic toxicity, febrile neutropenia, infection, sensory neuropathy, dyspnea and dehydration; researchers reported four deaths as grade 5 toxicities. “This combination treatment should be an option, particularly for patients with squamous histology who have limited alternative options,” Otterson said.
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