Real-World Evidence of Safety and Efficacy of Carboplatin plus Nanoparticle Albumin-Bound Paclitaxel in Patients with Advanced Non-Small-Cell Lung Cancer and Preexisting Interstitial Lung Disease: A Retrospective Study

الملخص EN

Background.

Standard chemotherapy for advanced non-small-cell lung cancer (NSCLC) with preexisting interstitial lung disease (ILD) has not yet been established.

Although a combination of carboplatin and paclitaxel is most frequently used for patients with advanced NSCLC and ILD, the safety and efficacy of carboplatin plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel) are yet to be elucidated.

Objectives.

This study aimed to evaluate the safety and efficacy of carboplatin plus nab-paclitaxel for advanced NSCLC with ILD.

Methods.

This retrospective study included nine patients with advanced NSCLC and ILD who received carboplatin plus nab-paclitaxel as first-line chemotherapy at the National Hospital Organization Kanazawa Medical Center between April 2013 and December 2017.

The ILD-GAP index was used to evaluate mortality risk of baseline ILD.

Results.

A usual interstitial pneumonia (UIP) pattern of ILD was observed in five (55.6%) patients on their baseline high-resolution computed tomography (HRCT) scans.

The median ILD-GAP index was 4 (range, 1–5), and six (66.7%) patients had ILD-GAP index ≥4.

We observed no ILD exacerbations or chemotherapy-related deaths.

The overall response and disease control rates were 77.8% (95% CI, 40.0–97.2) and 88.9% (95% CI, 51.8–97.2), respectively.

The median progression-free survival and overall survival were 5.8 months (95% CI, 2.1–7.7) and 8.0 months (95% CI, 2.6–16.8), respectively.

Conclusions.

Carboplatin plus nab-paclitaxel showed favorable safety and efficacy in patients who had advanced NSCLC and ILD with a high risk of mortality.

Prospective studies are required to further confirm these results.