Nab-paclitaxel as second-line treatment in advanced gastric cancer: a multicenter phase II study of the Hellenic Oncology Research Group

Abstract

Background:This study evaluated the safety and efficacy of nab-paclitaxel as second-line treatment in patients with advanced gastric adenocarcinoma.Methods:Thirty-nine pretreated patients [33 with taxane-based regimens (docetaxel, cisplatin, and fluorouracil)] and 6 with combination of fluoropyrimidines plus cisplatin with locally advanced inoperable and metastatic gastric and gastroesophageal junction adenocarcinoma were treated with weekly nab-paclitaxel (150 mg/m2 d1, d8, d15 in cycles of 28 days).Results:Partial response (PR) was documented in nine patients (23.1%; 95% confidence interval 10.1-37.2%), stable disease (SD) in 11 (28.2%) and disease progression in 18 (46.2%). The disease control rate (SD + PR + complete response) was 51.3%. Grade 3 and 4 neutropenia occurred in 10.2% and 5.1% of patients, respectively; grade 3 anemia in 5.1%; grade 3 neurotoxicity in 5.1%; and grade 2 pain in 5.1%. The median progression-free survival was 3.0 months (range 0.3-13.6) and the median overall survival 6.8 months (range 0.3-22).Conclusion:Nab-paclitaxel as second-line treatment in locally advanced inoperable or metastatic gastric and gastroesophageal junction carcinoma is an active chemotherapy regimen with a manageable toxicity profile and merits further evaluation.

Identification of novel prognostic biomarkers by integrating multi-omics data in gastric cancer

“…5 d). Studies have shown that nab-paclitaxel as second-line treatment in locally advanced inoperable or metastatic gastric and gastroesophageal junction carcinoma is a promising chemotherapy regimen [ 52 , 53 ].…”

Nab-PIPAC: a phase IB study protocol of intraperitoneal cisplatin and nab-paclitaxel administered by pressurised intraperitoneal aerosol chemotherapy (PIPAC) in the treatment of advanced malignancies confined to the peritoneal cavity

“…22 It has been studied intravenously in many solid tumours, including four phases II clinical trials for recurrent ovarian cancer [23][24][25][26] and in two phases II and a phase III trial for recurrent gastric adenocarcinoma. [27][28][29][30] IP administration of paclitaxel is a standard therapy for advanced epithelial ovarian carcinoma in North America, 31 but the IP administration of nabpaclitaxel has been little studied. IP administration of nab-paclitaxel has been evaluated in phase I trial in 27 patients with gynaecological and digestive PC, with an IP MTD of 140 mg/m 2 .…”

“…Nab-paclitaxel has fewer side effects, shows increased tumour cell cytotoxicity, and patients have higher overall response rates, compared with equal doses of solvent-based paclitaxel in many solid malignancies 22. It has been studied intravenously in many solid tumours, including four phases II clinical trials for recurrent ovarian cancer23–26 and in two phases II and a phase III trial for recurrent gastric adenocarcinoma 27–30. IP administration of paclitaxel is a standard therapy for advanced epithelial ovarian carcinoma in North America,31 but the IP administration of nab-paclitaxel has been little studied.…”

Nano drug delivery systems in upper gastrointestinal cancer therapy

“…GNPs-RNA conjugates are used in the coloriometric detection of biomarker micro-RNA in GC [ 147 ]. In the treatment of advanced GC and its metastasis, evidence indicates the improved effectiveness of nab-PAX [ 148 , 149 ]. These formulations could be used to increase the therapeutic value of the drugs by increasing the solubility.…”