Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Department of Respiratory Medicine, Aomori Prefectural Central Hospital, Aomori, Japan.
Clin Lung Cancer. 2021 Jan;22(1):42-48. doi: 10.1016/j.cllc.2020.09.016. Epub 2020 Oct 14.
Concurrent chemoradiotherapy (CCRT) is the standard treatment for patients with locally advanced non-small-cell lung cell cancer (LA-NSCLC). We conducted a phase I/II study of biweekly carboplatin and nab-paclitaxel (nab-PTX) with radiotherapy (RT).
In the phase I part, patients with inoperable stage IIIA/IIIB NSCLC were treated with carboplatin (area under the time-concentration curve, 4) and nab-PTX (60-100 mg/m) on days 1, 15, and 29. Thoracic RT was administered from day 1 to a total dose of 60 Gy in 30 fractions. In the phase II part, patients were administered carboplatin and nab-PTX on days 1, 15, and 29 at the recommended dose (RD). The primary endpoint of the phase I part was to determine the maximum tolerated dose and the RD. In the phase II part, the primary endpoint was 2-year overall survival (OS) rate, and secondary endpoints were the objective response rate, progression-free survival, OS, and safety profile.
In the phase I part, although maximum tolerated dose was not obtained, the RD was carboplatin (area under the time-concentration curve, 4) and nab-PTX (100 mg/m). Of the evaluable 28 patients, the rate of 2-year OS was 67.8% (95% confidence interval, 49.3%-82.1%). The objective response rate was 96.4%, and the median follow-up time was 33.2 months. The median progression-free survival was 18.2 months (95% confidence interval, 13.1 months to not reached). The most common toxicities of grade 3 or higher were neutropenia (60.5%), anemia (14.2%), thrombocytopenia (7.2%), and pneumonitis (3.6%).
This study achieved the primary endpoint. Biweekly carboplatin and nab-PTX with concurrent RT was well-tolerated and exerted promising antitumor activity.
同期放化疗(CCRT)是局部晚期非小细胞肺癌(LA-NSCLC)患者的标准治疗方法。我们进行了一项 II 期研究,评估了卡铂和nab-紫杉醇(nab-PTX)联合放疗(RT)的疗效。
在 I 期部分,无法手术的 IIIA/IIIB 期 NSCLC 患者接受卡铂(AUC4)和 nab-PTX(60-100mg/m)治疗,第 1、15 和 29 天给药。从第 1 天开始给予胸部 RT,总剂量为 60Gy,分 30 次进行。在 II 期部分,推荐剂量(RD)下患者在第 1、15 和 29 天接受卡铂和 nab-PTX 治疗。I 期部分的主要终点是确定最大耐受剂量和 RD。II 期部分的主要终点是 2 年总生存率(OS)率,次要终点是客观缓解率、无进展生存期、OS 和安全性。
在 I 期部分,尽管未达到最大耐受剂量,但 RD 为卡铂(AUC4)和 nab-PTX(100mg/m)。在可评估的 28 例患者中,2 年 OS 率为 67.8%(95%置信区间,49.3%-82.1%)。客观缓解率为 96.4%,中位随访时间为 33.2 个月。中位无进展生存期为 18.2 个月(95%置信区间,13.1 个月至未达到)。最常见的 3 级或以上毒性为中性粒细胞减少(60.5%)、贫血(14.2%)、血小板减少(7.2%)和肺炎(3.6%)。
该研究达到了主要终点。卡铂和 nab-PTX 联合同期 RT 耐受性良好,具有良好的抗肿瘤活性。