nab-paclitaxel for the management of patients with advanced non-small-cell lung cancer

Abstract

The 130 nm albumin-bound form of paclitaxel, nab-paclitaxel (Abraxane^®), was recently approved by the US FDA for the first-line treatment of locally advanced or metastatic non-small-cell lung cancer (NSCLC) in combination with carboplatin in patients who are not candidates for curative surgery or radiation therapy. In a Phase III registrational trial, nab-paclitaxel plus carboplatin demonstrated a significantly improved overall response rate, the primary endpoint, and a trend toward improved survival compared with solvent-based paclitaxel plus carboplatin in patients with advanced NSCLC. Significantly less neutropenia, neuropathy, arthralgia, and myalgia were observed with the nab-paclitaxel regimen, but the solvent-based paclitaxel regimen produced less thrombocytopenia and anemia. The clinical experience with nab-paclitaxel to date and the role of this newly approved therapy in the management of NSCLC will be summarized in this article.

Keywords::

• elderly
• histology
• nab-paclitaxel
• non-small-cell lung cancer
• taxanes

Financial & competing interests disclosure

V Hirsh serves in a consultant or advisory role for Celgene Corporation. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Medical writing assistance was provided by C Carter, Meditech Media, funded by Celgene Corporation. The author is fully responsible for the content and editorial decisions for this review.

Key issues

• nab-paclitaxel is effective in advanced non-small-cell lung cancer.

• nab-paclitaxel plus carboplatin demonstrated activity in patients with advanced non-small-cell lung cancer regardless of age or histology.

• The main side effects of nab-paclitaxel plus carboplatin are hematological abnormalities; patients experiencing grade 3/4 peripheral neuropathy associated with this regimen experience a faster time to improvement compared with patients receiving solvent-based paclitaxel plus carboplatin.

• Specialized administration tubing and standard premedications to prevent hypersensitivity reactions are not required with nab-paclitaxel.

Notes