Nab-paclitaxel as First Line Treatment for NSCLC in Elderly Patients More Than 75 Years Old

Abstract

Introduction: Lung cancer is still the leading cause of cancer among cancer patients. Although there are novel therapies as second line treatment for NSCLC, there is an issue for elderly patients. Patients and Methods: We collected retrospectively data from 60 patients >75 years of age. Thirty of these patients received nab-paclitaxel and first line treatment and were compared to thirty patients that received only best supportive care. Results: The median life of patients at the date of disease progression, although increased by the administration of the drug (92 days versus 70) was not confirmed statistically significantly (Mann-Whitney test: W = 280, p = 0.138). The administration of drug seems to keep stable the biological condition of patients (McNemar's test: χ2 = 0.033, p = 0.99). Patients with chemotherapy the death rate was increased by 50% as compared to those with best supportive care (12 vs 8), the median life until the unfortunate event surpassed statistically significantly the latter (150 days of life as compared to 108, Mann-Whitney test: W = 57.5, p = 0.045). Discussion: Nab-paclitaxel as a monotherapy could be considered as a first line treatment option for patients > 75 years of age without any previous cardiological medical history when compared to best supportive care.

Chronic Obstructive Pulmonary Disease and Non-Small Cell Lung Cancer an association

“…The administration of one drug in the final phase was reduced to 50% (14 patients), that of 2 and 4 drugs remained stable but nebulizer increased 4-fold including 17 patients. The drug shift pairs showed a steady and unchanged by time health condition for 48 patients (11,22,33,44), that is 58.6% of the total sample (Table 2), a shift by one more drug for levels 12 (17.1%), 23 (14.6%) and 34 (2.4%) and surprisingly an inverse shift 43 for 3 patients (3.7%). Overall, 31 patients were recorded with worse COPD health conditions.…”

“…Biomarkers were tested with t-test and one-way ANOVA on how potentially have been influenced by the FEV1-diff and COPD conditions (Table 3). FEV 1 -difference was reformed to positive and negative values and COPD drug pair shifts to stable (11,22,33,44), positive (43) and negative (12,23,34,24) values. A sole statistically significant effect was recorded and that for BMI (p=0.042) which manifested an improvement in value at the negative FEV1 phase (0.30>-0.69).…”

“…In our study we included non-small cell lung cancer (NSCLC) patients. Currently we have several treatments for non-operable non-small cell lung cancer (NSCLC) patients with chemotherapy, radiotherapy, tyrosine kinase inhibitors, immunotherapy or combinations [4,[9][10][11]. After we acquire biopsy we investigate for the following gene expressions epidermal growth factor receptor (EGFR) or T790M, anaplastic lymphoma kinase (ALK), Programmed death-ligand 1 (PD-L1), Proto-oncogene tyrosine-protein kinase (ROS-1), proto-oncogene encodes and proto-oncogene (B-Raf) [10,12].…”

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

“…A retrospective analysis of the NCT00540514 trial showed that nab‐paclitaxel combined with carboplatin had better ORR (46% vs. 20%), OS (20 vs. nine months) and tolerability compared with sb‐P/C in elderly patients with NSCLC . Zarogoulidis et al . showed that first‐line nab‐paclitaxel monotherapy had better outcomes compared with best supportive care in patients ≥75 years of age with NSCLC.…”

Lung cancer, treatment and nutritional status

“…Moreover; we can perform transthoracic biopsy with convex probe or computed tomography guided biopsies (2)(3)(4)(5)(6)(7). Currently we have several treatments for non-operable non-small cell lung cancer (NSCLC) with chemotherapy, radiotherapy, tyrosine kinase inhibitors, immunotherapy or combinations (8)(9)(10)(11).…”