Retrospective analysis of the effectiveness and tolerability of nab‐paclitaxel in Chinese elderly patients with advanced non‐small‐cell lung carcinoma

BACKGROUND: Previous trials have suggested that elderly patients with non‐small‐cell lung cancer (NSCLC) could benefit from nanoparticle albumin‐bound paclitaxel (nab‐paclitaxel). Real‐world data on the elderly Chinese population are lacking. This study aimed to analyze the effectiveness and tolerability of nab‐paclitaxel in Chinese elderly patients (≥65 years) with advanced NSCLC. METHODS: This study included 76 patients with a primary diagnosis of IIIB‐IV NSCLC from January 2010 to December 2017 at Peking University Cancer Hospital, who received nab‐paclitaxel (125 or 130 mg/m(2) i.v.) every three weeks. The overall survival (OS), progression‐free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were analyzed. RESULTS: There were 12 patients who received nab‐paclitaxel as the first‐line treatment (seven also received carboplatin), and 64 received nab‐paclitaxel as the latter‐line treatment. The overall ORR, DCR, median PFS, and median OS were 14.5%, 69.7%, 5.2 months, and 12.2 months, respectively. The Eastern Cooperative Oncology Group performance status of one and the age of 70–74 years were independently associated with longer OS, while early treatment line of nab‐paclitaxel and age of 70–74 years were independently associated with longer PFS. The most common AEs were anemia, leukopenia, gastrointestinal reaction, fatigue, and peripheral neuropathy, which were all manageable. Dose adjustment or treatment discontinuation was encountered in 10 patients because of AEs. The incidence of AEs was not different among age subgroups. CONCLUSIONS: Nab‐paclitaxel has a good clinical response profile in Chinese elderly patients with stage IIIB–IV NSCLC. Prospective clinical trials are needed to confirm these results. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: Nanoparticle albumin‐bound paclitaxel (nab‐paclitaxel) has a good clinical response profile in Chinese elderly (≥65 years) patients with stage IIIB‐IV non‐small‐cell lung cancer (NSCLC), with acceptable and manageable adverse events. WHAT THIS STUDY ADDS: Preliminary evidence shows a good clinical response from treatment with nab‐paclitaxel in Chinese elderly patients with advanced NSCLC.