• NEW YORK In early studies, the albumin-bound 130-nm formulation of paclitaxel (nab-paclitaxel, Abraxane) has shown promise in first-line treatment of non-small-cell lung cancer (NSCLC). Speaking at a presentation held in conjunction with the Chemotherapy Foundation Symposium XXIV, Chandra Belani, MD, highlighted current investigations of nab-paclitaxel as single-agent and combination therapy for NSCLC. Dr. Belani is professor of medicine and co-director of the Lung and Thoracic Malignancies Program at the University of Pittsburgh Cancer Institute.
The presentation was supported by an educational grant from Abraxis Oncology, the developer of Abraxane. The agent is FDA approved as second-line treatment of metastatic breast cancer.
Dr. Belani reviewed several completed and ongoing investigations of nab-paclitaxel as first-line therapy in NSCLC:
• In a multicenter phase II study, Mark Green, MD, of the Medical University of South Carolina, Charleston, and colleagues reported what Dr. Belani described as "provocative early data" in an evaluation of single-agent first-line nab-paclitaxel at 260 mg/m2 every 3 weeks in NSCLC (Ann Oncol 17:1263-1268, 2006). In 43 enrolled patients, overall response was 16%, and disease control rate was 49%. Median time to progression (TTP) was 6 months, and median survival was 11 months.
Nearly all patients (95%) were treated without dose reduction. No grade 4 treatment-related toxicities occurred. Two patients discontinued treatment because of a grade 3 toxicity (neuropathy in one patient, fatigue in the other).
• In a phase I dose-finding study, Naiyer A. Rizvi, MD, of Memorial Sloan-Kettering Cancer Center, and colleagues administered weekly nab-paclitaxel to chemonaive patients with stage IV NSCLC. Patients received nab-paclitaxel at 100, 125, 150, and 175 mg/m2 on days 1, 8, and 15 every 28 days. Dose-limiting toxicities occurred with the 150 mg/m2 dose, and the MTD for phase II was determined to be 125 mg/m2.