Is there a role of nab-paclitaxel in the treatment of advanced non-small cell lung cancer? The data suggest yes

Abstract

Nab-paclitaxel is a novel therapeutic agent, which was approved in combination with carboplatin in the first-line treatment of advanced non-small cell lung cancer (NSCLC) regardless of histologic subtype in the United States of America by the Food and Drug Administration in 2012 and by the European Commission in 2015. This approval was based on the results of a phase III clinical trial showing superior response rates compared with solvent-based paclitaxel in combination with carboplatin. This review will focus on the early development and clinical data to date supporting the use of nab-paclitaxel in advanced NSCLC. The clinical question central to this review is whether nab-paclitaxel has a place in the current therapeutic landscape of advanced NSCLC.

Keywords: Carboplatin; Elderly; Nab-paclitaxel; Neuropathy; Non-small cell lung cancer (NSCLC); Squamous cell histology.

Fig. 1

Overall response rate of nab-paclitaxel/carboplatin (nab-PC) and solvent-based paclitaxel/carboplatin (sb-PC) on the basis of independent assessment in a randomized phase III clinical trial comparing nab-PC versus sb-PC in newly diagnosed advanced non-small cell lung cancer patients, in the intention-to-treat (ITT) population and by histology.

Fig. 2

Composite change for the Functional Assessment of Cancer Therapy-Taxane subscale at baseline and prior to dosing on day 1 of each cycle on a randomized phase III clinical trial comparing nab-paclitaxel/carboplatin (nab-PC) versus solvent-based paclitaxel/carboplatin (sb-PC) in patients with newly diagnosed advanced non-small cell lung cancer. Larger bars represent greater deteriorations from baseline as perceived by patients. Reprinted with permission from J Thorac Oncol. 2014;9: 83–90.

Fig. 3

Kaplan–Meier curves of progression-free survival (top) and overall survival (OS, bottom) in the elderly (≥70 years of age) patients treated on a randomized phase III clinical trial comparing nab-paclitaxel/carboplatin (nab-PC) versus solvent-based paclitaxel/carboplatin (sb-PC) in patients with newly diagnosed advanced non-small cell lung cancer. Reprinted with permission from Annals of Oncology 24: 314–321, 2013.