nab-Paclitaxel/carboplatin in elderly patients with advanced squamous non-small cell lung cancer: a retrospective analysis of a Phase III trial.

Background: Limited data on elderly patients with squamous advanced non-small cell lung cancer (NSCLC) preclude optimal treatment. Here, we report the outcomes of a retrospective analysis of a subset of patients ≥70 years with squamous histology from the Phase III trial that evaluated nab-paclitaxel/carboplatin vs paclitaxel/carboplatin.
Patients and Methods: Patients with stage IIIB/IV NSCLC received (1:1) nab-paclitaxel 100 mg/m ² on days 1, 8, and 15 or paclitaxel 200 mg/m ² on day 1, both with carboplatin area under the curve 6 mg×min/mL on day 1 every 3 weeks. The primary endpoint was independently assessed overall response rate as per the Response Evaluation Criteria in Solid Tumors v1.0. Secondary endpoints included progression-free survival, overall survival, and safety.
Results: Sixty-five patients ≥70 years with squamous histology were included (nab-paclitaxel/carboplatin, n=35; paclitaxel/carboplatin, n=30). nab-Paclitaxel/carboplatin vs paclitaxel/carboplatin, respectively, resulted in an overall response rate of 46% vs 20% (response rate ratio, 2.29, P =0.029) and a median overall survival of 16.9 vs 8.6 months (hazard ratio, 0.50, P =0.018). No difference was observed in median progression-free survival (5.7 months for both). Incidences of grade 3/4 neutropenia (50% vs 63%), leukopenia (29% vs 37%), fatigue (3% vs 13%), and peripheral neuropathy (3% vs 13%) were lower, but those of thrombocytopenia (21% vs 10%) and anemia (21% vs 7%) were higher with nab-paclitaxel/carboplatin vs paclitaxel/carboplatin.
Conclusion: nab-Paclitaxel/carboplatin was efficacious and tolerable in patients ≥70 years with squamous NSCLC. These results build upon prior analyses, indicating that nab-paclitaxel/carboplatin is effective for this difficult-to-treat patient subgroup.
Competing Interests: Disclosure TC, AK, TJO: employment or leadership position and stock ownership, Celgene Corporation. MEO: advisory role, Celgene, GSK, BMS, Pierre Fabre, Medimmune, MSD, Pfizer, Daichii Sankyo. MAS: honoraria and speaker’s bureau, Celgene. PEP: advisory board member of Celgene, Boehringer Ingelheim, Halozyme, Teva, Clovis Oncology, Eli Lilly. The authors report no other conflicts of interest in this work.