Background: Albumin-bound paclitaxel is a novel paclitaxel formulation formed by the combination of paclitaxel and human serum albumin (HSA) to improve the efficacy of paclitaxel and reduce its adverse reactions. The aim of this retrospective study is to observe the efficacy and safety of albumin-bound paclitaxel-based therapy in the treatment of lung cancer.
Methods: We have enrolled 50 patients with advanced or unresectable retreatment lung cancer who were admitted from November 2011 to December 2014. All patients were treated with albumin-bound paclitaxel-based therapy with a 21 day cycle (albumin-bound paclitaxel weekly by intravenous dose of 130 mg/m2 on day 1 and day 8). Efficacy was evaluated every two cycles according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and side effects were observed during each cycle. All patients were evaluated.
Results: The total objective response rate (ORR) of albumin-bound paclitaxel-based therapy was 20%, disease control rate (DCR) was 68%. In the subgroup analysis, in squamous non-small-cell lung carcinoma groups, ORR and DCR were 26.7% and 80% respectively. Albumin-bound paclitaxel based chemotherapy combined anti-angiogenesis therapy had a promising overall response rate 36.4%. In the patients who had been previously treated with≥4 lines of chemotherapy DCR also reached 69.2%. The most common adverse reactions were hematologic toxicities and were all manageable, no hypersensitivity reactions or treatment-related grade 4 adverse events were reported.
Conclusions: Weekly albumin-bound paclitaxel is effective and well tolerated in the treatment of advanced lung cancer including all histological subtypes. Albumin-bound paclitaxel was associated with superior efficacy in patients with squamous (SCC) histology and combined with anti-angiogenesis therapy. Albumin-bound paclitaxel shown to be an effective and safe regimen for elderly or previous heavily treated patients.
背景与目的 白蛋白结合型紫杉醇是通过将人血白蛋白与紫杉醇相结合的无需助溶剂的新型紫杉醇制剂，本研究旨在观察白蛋白结合型紫杉醇治疗晚期肺癌的临床疗效及其安全性。方法 选取2011年11月-2014年12月收治的进展期/不可手术的晚期肺癌患者共50例。给予白蛋白结合型紫杉醇130 mg/m2，第1天、第8天单药方案或者联合方案治疗，21 d为1个周期，观察每个周期不良反应，每2个周期按实体瘤疗效评价标准（Response Evaluation Criteria in Solid Tumors, RECIST）1.1进行影像学疗效评价。结果 白蛋白结合型紫杉醇治疗总体客观有效率（overall response rate, ORR）为20%，疾病控制率（disease control rate, DCR）为68%。在亚组分析中，鳞癌ORR为26.7%，DCR为80%，明显优于其他病理类型，但是尚未达到统计学差异。以白蛋白结合型紫杉醇单药或者两药联合的基础上联合抗血管生成治疗可以提高ORR（36.4% vs 15.4%）。四线及以上治疗患者DCR仍可达到69.2%。主要不良反应为血液学毒性但是可控制，无超敏反应及4级不良反应发生。结论 白蛋白结合型紫杉醇为基础的治疗方案治疗晚期肺癌无论其病理类型及治疗线数均有一定疗效，对于鳞癌及与抗血管靶向治疗联合时更有优势，即使对于老年及多线治疗后的患者耐受性较好。.