nab-paclitaxel-based therapy in underserved patient populations: The ABOUND.70+ study in elderly patients with advanced NSCLC

Corey J. Langer, Edward S. Kim, Eric C. Anderson, Robert M. Jotte, Manuel Modiano, Daniel E. Haggstrom, Matei P. Socoteanu, David A. Smith, Christopher Dakhil, Kartik Konduri, Tymara Berry, Teng J. Ong, Alexandra Sanford, Katayoun Amiri, Jonathan W. Goldman, Jared Weiss

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

The phase 4 ABOUND.70+ trial assessed the safety and efficacy of nab-paclitaxel/carboplatin continuously or with a 1-week break between cycles in elderly patients with advanced non-small cell lung cancer (NSCLC). Patients ≥70 years with locally advanced/metastatic NSCLC were randomized 1:1 to first-line nab-paclitaxel days 1, 8, 15 plus carboplatin day 1 of a 21-day cycle (21d) or the same nab-paclitaxel/carboplatin regimen with a 1-week break between cycles (21d + break; 28d). The primary endpoint was the percentage of patients with grade ≥ 2 peripheral neuropathy (PN) or grade ≥ 3 myelosuppression. Other key endpoints included progression-free survival (PFS), overall survival (OS), and overall response rate (ORR). A total of 143 patients were randomized (71 to 21d, 72 to 21d + break). The percentage of patients with grade ≥ 2 PN or grade ≥ 3 myelosuppression was similar between the 21d and 21d + break arms (76.5 and 77.1%; P = 0.9258). Treatment exposure was lower in the 21d arm compared with the 21d + break arm. Median OS was 15.2 and 16.2 months [hazard ratio (HR) 0.72, 95% CI 0.44-1.19; P = 0.1966], median PFS was 3.6 and 7.0 months (HR 0.48, 95% CI 0.30-0.76; P < 0.0019), and ORR was 23.9 and 40.3% (risk ratio 1.68, 95% CI 1.02-2.78; P = 0.0376) in the 21d and 21d + break arms, respectively. In summary, the 1-week break between treatment cycles significantly improved PFS and ORR but did not significantly reduce the percentage of grade ≥ 2 PN or grade ≥ 3 myelosuppression. Overall, the findings support the results of prior subset analyses on the safety and efficacy of first-line nab-paclitaxel/carboplatin in elderly patients with advanced NSCLC.

Original languageEnglish (US)
Article number262
JournalFrontiers in Oncology
Volume8
Issue numberJUL
DOIs
StatePublished - Jul 24 2018

Keywords

  • Advanced non-small cell lung cancer
  • Carboplatin
  • Elderly
  • Nab-paclitaxel
  • Phase 4
  • Randomized trial

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Langer, C. J., Kim, E. S., Anderson, E. C., Jotte, R. M., Modiano, M., Haggstrom, D. E., Socoteanu, M. P., Smith, D. A., Dakhil, C., Konduri, K., Berry, T., Ong, T. J., Sanford, A., Amiri, K., Goldman, J. W., & Weiss, J. (2018). nab-paclitaxel-based therapy in underserved patient populations: The ABOUND.70+ study in elderly patients with advanced NSCLC. Frontiers in Oncology, 8(JUL), [262]. https://doi.org/10.3389/fonc.2018.00262