Safety and efficacy of carboplatin plus nab-paclitaxel for treating advanced non-small-cell lung cancer with interstitial lung disease

Abstract

Abstract. There are few established treatments for patients with non-small-cell lung cancer (NSCLC) with interstitial lung disease (ILD). The safety and efficacy of albumin-bound paclitaxel (nab-paclitaxel) in combination with carboplatin is uncertain, although the combination of carboplatin and paclitaxel is the most common regimen for treating NSCLC patients with ILD. A total of 9 NSCLC patients with ILD, treated between April 2013 and March 2016, were retrospectively investigated. Carboplatin (AUC 5-6) was administered on day 1 and nab-paclitaxel on days 1, 8 and 15, every 4-6 weeks. The median age of the patients upon initiating chemotherapy was 67 years. The pathological examination revealed 6 patients with squamous cell carcinoma, and 6 patients exhibited the typical pattern of ILD. The response rate was 55.6%, and the median progression-free and overall survival time was 174 and 344 days, respectively. Acute exacerbation of ILD was not observed in any of the patients, and febrile neutropenia developed in 3 patients (3/9, 33.3%). Thus, treatment with carboplatin plus nab-paclitaxel was found to be safe and effective for NSCLC patients with ILD, although management of hematological adverse events, such as febrile neutropenia, was required. However, these encouraging results require confirmation by a large-scale clinical trial.

Phase II study of nab‐paclitaxel + carboplatin for patients with non‐small‐cell lung cancer and interstitial lung disease

“…Several retrospective studies have reported median survival of 5.4‐11.4 months for NSCLC patients with ILD treated with chemotherapy . In addition, 2 small retrospective studies evaluating a combination of nab‐paclitaxel with carboplatin for NSCLC patients with ILD (median OS, 11.8 and 14.9 months, respectively) supported the survival data of the present study …”

The Safety and Efficacy of Treatment with Nab-paclitaxel and Carboplatin for Patients with Advanced Squamous Non-small Cell Lung Cancer Concurrent with Idiopathic Interstitial Pneumonias

“…Recently, other groups have also reported the favorable efficacy and safety of the nab-PC regimen for treating advanced NSCLC patients with ILD ( 27 , 28 ). Reported values for the median ORR, PFS and OS were 56-67%, 5.1-5.8 months and 11.5-14.9 months, respectively, and AE-ILD developed in 0-8.3%.…”

The Efficacy and Safety of First-Line Chemotherapy in Patients With Non-small Cell Lung Cancer and Interstitial Lung Disease: A Systematic Review and Meta-Analysis

“…In our analysis, patients with SCC accounted for a relatively high proportion, especially in the nab-PTX group (Table 1). Therefore, some studies have selection bias (34,35,37) and caused ORR in our analysis to be significantly higher than patients without ILD.…”

“…Chemotherapy is still the main treatment regimen for NSCLC patients with preexisting ILD. A series of studies (13)(14)(15)(16)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39) have investigated the risk and benefit of chemotherapy for NSCLC-ILD; however, all of these studies are single-arm trials, and part of them have a small sample size. Therefore, it is necessary to summarize the existing data to provide a basis for future clinical studies.…”

“…Second, we included many retrospective studies that may produce selective bias, and more high-quality studies are needed to verify our results in the future. Third, three studies had small sample sizes (34,35,37) and might cause heterogeneity. However, no statistical heterogeneity was observed.…”