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Clinical roundtable monograph: Recent advances in taxanes for the first-line treatment of advanced non-small cell lung cancer.

Abstract
Treatments for non-small cell lung cancer (NSCLC) are based on the broad categories of squamous or non-squamous histology. Frontline treatment options include pemetrexed and cisplatin, pemetrexed and a taxane, gemcitabine with cisplatin, and the addition of bevacizumab to a taxane and carboplatin. Pemetrexed is used for maintenance therapy for non-squamous NSCLC, whereas patients with squamous NSCLC lack easy options for maintenance therapy. nab-Paclitaxel overcomes the solubility and toxicity issues of solvent-based paclitaxel, and the albumin in nab-paclitaxel improves the concentration of the drug in the tumor. A recent phase III trial in NSCLC compared nab-paclitaxel with carboplatin versus solvent-based paclitaxel with carboplatin, and found improved overall response rates (ORRs) in the nab-paclitaxel arm (33% vs 25%; P=.005). In a subset analysis, NSCLC patients with squamous histology had a higher ORR (41%) with nab-paclitaxel than with solvent-based paclitaxel (24%; P<.001). Another subset analysis found that patients ages 70 years and older had improved overall survival (median 19.9 months) with nab-paclitaxel compared with solvent-based paclitaxel (median 10.4 months; P=.009). Patients in the nab-paclitaxel arm had less neuropathy, less hearing loss, and fewer interruptions in daily living than patients in the solvent-based paclitaxel arm.
AuthorsMark A Socinski, Ramaswamy Govindan, David Spigel
JournalClinical advances in hematology & oncology : H&O (Clin Adv Hematol Oncol) Vol. 10 Issue 10 Suppl 18 Pg. 1-16 (Oct 2012) ISSN: 1543-0790 [Print] United States
PMID23187688 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antineoplastic Agents
  • Taxoids
  • ErbB Receptors
Topics
  • Age Factors
  • Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
  • Carcinoma, Non-Small-Cell Lung (drug therapy, mortality, pathology)
  • Clinical Trials as Topic
  • ErbB Receptors (genetics, metabolism)
  • Humans
  • Lung Neoplasms (drug therapy, mortality, pathology)
  • Maintenance Chemotherapy
  • Neoplasm Staging
  • Taxoids (administration & dosage, adverse effects, therapeutic use)
  • Treatment Outcome

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