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Combination treatment may benefit NSCLC patients ineligible for bevacizumab

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Patients with non–small cell lung cancer who are not eligible for treatment with bevacizumab may benefit from treatment with a combination of nab-paclitaxel and carboplatin, according to phase 2 study results.

Gregory A. Otterson, MD, co-director of the thoracic oncology program at The Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus, Ohio, and colleagues conducted a single-arm, single-institution study in which they evaluated the drug combination in 63 patients with advanced non–small cell lung cancer (NSCLC).

The primary endpoint was response rate. Secondary endpoints were OS and PFS.

All patients were ineligible for bevacizumab because of squamous histology, thrombosis, history of hemoptysis or a requirement for anticoagulation. The median age was 63, and 42 of the patients were men. Patients had an average 50 pack-year tobacco history.

The patients initially received 300 mg/m2 of the drug combination every 21 days. The treatment later was adjusted to 260 mg/m2 due to excess neuropathy, the researchers said.

Among 53 patients available for evaluation, researchers found an overall response rate of 41%. Another 39% had stable disease for at least 6 weeks, while disease progressed in 19% of patients, the researchers said.

“We have been surprised at the durability of response, with some patients not requiring further treatment for at least 6 months,” Otterson said.

Data on OS and PFS are not yet available.

Grade-3/4 toxicities seen in more than 10% of patients included hematologic toxicity (57%), sensory neuropathy (27%), infection (24%), dyspnea (16%), febrile neutropenia (14%) and dehydration (13%). The researchers reported four deaths as grade-5 toxicities.

“The combination of carboplatin and nab-paclitaxel demonstrates promising efficacy with tolerable toxicity in patients with non–small cell lung cancer [who are] ineligible for therapy with bevacizumab,” Otterson said.

Further study in the squamous cell population is warranted, the researchers said.

For more information:

• Otterson GA. Abstract #LB-225. Presented at: 2012 AACR Annual Meeting; March 31-April 4; Chicago.