Real-World Evidence of Safety and Efficacy of Carboplatin plus Nanoparticle Albumin-Bound Paclitaxel in Patients with Advanced Non-Small-Cell Lung Cancer and Preexisting Interstitial Lung Disease: A Retrospective Study

• Published in: Canadian respiratory journal 2019-01, Vol.2019 (2019), p.1-7
• Main Authors: Kimura, Hideharu, Kasahara, Kazuo, Sone, Takashi, Kurokawa, Koji, Yamamura, Kenta, Sakai, Tamami, Terada, Nanao, Ueda, Tsukasa, Kita, Toshiyuki, Araya, Tomoyuki, Uchida, Yuka
• Format: Article
• Language: English
• Subjects: Aged; Albumin; Albumin-Bound Paclitaxel - therapeutic use; Analysis; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols; Cancer; Cancer therapies; Carboplatin; Carboplatin - therapeutic use; Carcinoma, Non-Small-Cell Lung - complications; Carcinoma, Non-Small-Cell Lung - drug therapy; Care and treatment; Chemotherapy; Clinical medicine; Clinical Study; Cytotoxicity; Drug dosages; Female; Health aspects; Humans; Japan; Lung cancer; Lung cancer, Non-small cell; Lung diseases; Lung Diseases, Interstitial - complications; Lung Neoplasms - complications; Lung Neoplasms - drug therapy; Male; Middle Aged; Mortality; Nanoparticles; Oncology; Oncology, Experimental; Paclitaxel; Patients; Pemetrexed; Pulmonary fibrosis; Response rates; Retrospective Studies; Statistical analysis
• ISSN: 1198-2241; 1916-7245
• DOI: 10.1155/2019/5315903

Background. Standard chemotherapy for advanced non-small-cell lung cancer (NSCLC) with preexisting interstitial lung disease (ILD) has not yet been established. Although a combination of carboplatin and paclitaxel is most frequently used for patients with advanced NSCLC and ILD, the safety and efficacy of carboplatin plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel) are yet to be elucidated. Objectives. This study aimed to evaluate the safety and efficacy of carboplatin plus nab-paclitaxel for advanced NSCLC with ILD. Methods. This retrospective study included nine patients with advanced NSCLC and ILD who received carboplatin plus nab-paclitaxel as first-line chemotherapy at the National Hospital Organization Kanazawa Medical Center between April 2013 and December 2017. The ILD-GAP index was used to evaluate mortality risk of baseline ILD. Results. A usual interstitial pneumonia (UIP) pattern of ILD was observed in five (55.6%) patients on their baseline high-resolution computed tomography (HRCT) scans. The median ILD-GAP index was 4 (range, 1–5), and six (66.7%) patients had ILD-GAP index ≥4. We observed no ILD exacerbations or chemotherapy-related deaths. The overall response and disease control rates were 77.8% (95% CI, 40.0–97.2) and 88.9% (95% CI, 51.8–97.2), respectively. The median progression-free survival and overall survival were 5.8 months (95% CI, 2.1–7.7) and 8.0 months (95% CI, 2.6–16.8), respectively. Conclusions. Carboplatin plus nab-paclitaxel showed favorable safety and efficacy in patients who had advanced NSCLC and ILD with a high risk of mortality. Prospective studies are required to further confirm these results.