Efficacy and safety of weekly intravenous nanoparticle albumin‐bound paclitaxel for non‐small cell lung cancer patients who have failed at least two prior systemic treatments

BACKGROUND: The study was conducted to evaluate the efficacy and safety of weekly intravenous nanoparticle albumin‐bound paclitaxel (NAB‐paclitaxel) treatment in patients with advanced non‐small‐cell lung cancer (NSCLC) who have undergone multi‐line therapy, and to investigate the association of secreted protein acidic and rich in cysteine (SPARC) expression status with clinical outcome. METHODS: Sixty‐four patients who received NAB‐paclitaxel treatment (130 mg/m(2) on days 1 and 8 of a 21 day cycle) as third line or further systemic treatment from 1 May 2011 to 30 June 2014 were included in this retrospective analysis. Tumor tissue was available in 28 patients for analysis of SPARC expression by immunohistochemistry. RESULTS: Sixty‐two patients had response evaluation and complete survival follow‐up data; 83.9% received the weekly NAB‐paclitaxel as fourth‐line treatment or beyond. The objective response and disease control rates (n = 62) were 16.1% (10/62) and 64.5% (40/62), respectively. The median progression‐free and overall survival rates were 3.7 (95% confidence interval 2.6–4.8) and 9.8 months (95% confidence interval 6.9–12.8), respectively. Previous treatment with taxane did not affect the response to NAB‐paclitaxel. The main grade 3–4 toxicities experienced were neutropenia (9.4%) and leukopenia (7.8%). Patients with SPARC expression in tumor stroma but not in cancer cells had poorer progression‐free survival compared with those with negative SPARC expression in tumor stroma cells (3.3 vs. 5.0 months, P = 0.036). CONCLUSION: Weekly NAB‐paclitaxel might be effective for heavily pretreated NSCLC patients. SPARC expression in tumor stroma cells might be a potential negative predictor of NAB‐paclitaxel.