title: 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.
abstract: 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.
  
  
  
  Sixty-four patients who received NAB-paclitaxel treatment (130 mg/m2on 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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Beijing Institute of Cancer Research, Beijing, China.
authors.forename: Jianchun
authors.initials: J
authors.lastname: Duan
authors.affiliation: Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao, China.
authors.forename: Yueqin
authors.initials: Y
authors.lastname: Hao
authors.affiliation: Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Beijing Institute of Cancer Research, Beijing, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wan
authors.affiliation: Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Beijing Institute of Cancer Research, Beijing, China.
authors.forename: Sifan
authors.initials: S
authors.lastname: Yu
authors.affiliation: Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Beijing Institute of Cancer Research, Beijing, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Bai
authors.affiliation: Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Beijing Institute of Cancer Research, Beijing, China.
authors.forename: Tongtong
authors.initials: T
authors.lastname: An
authors.affiliation: Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Beijing Institute of Cancer Research, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Beijing Institute of Cancer Research, Beijing, China.
authors.forename: Zhijie
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Beijing Institute of Cancer Research, Beijing, China.
authors.forename: Minglei
authors.initials: M
authors.lastname: Zhuo
authors.affiliation: Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Beijing Institute of Cancer Research, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000068196:Albumin-Bound Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D001952:Bridged-Ring Compounds / Q000008:administration & dosage / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D018572:Disease-Free Survival; D064420:Drug-Related Side Effects and Adverse Reactions / Q000473:pathology*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D053758:Nanoparticles / Q000008:administration & dosage / Q000737:chemistry; D015676:Osteonectin / Q000235:genetics*; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000068196:Albumin-Bound Paclitaxel; D001952:Bridged-Ring Compounds; D015676:Osteonectin; C577241:SPARC protein, human; D043823:Taxoids; C080625:taxane
keywords: Nanoparticle albumin-bound paclitaxel (NAB-paclitaxel); non-small-cell lung cancer (NSCLC); secreted protein acidic and rich in cysteine (SPARC)