The Exploration Of Chemotherapy For Advanced Non-small Cell Lung Cancer

Objective:This study aims to explore the application of actual carboplatin in carboplatin plus pemetrexed regimen as first-line treatment for advanced lung adenocarcinoma,and to determine the recommended dose of carboplatin for Chinese populations.Methods:From January 2014 to April 2016,151 advanced lung adenocarcinoma patients who received carboplatin and pemetrexed(500 mg/m2)as first line were included.The area under the curve(AUC)of carboplatin was back-calculated from actual dosages using the Calvert formula.According to the median of calculated AUC,patients were divided into AUC ?4 and<4 groups.Results:The median of AUC was 4(1.8-5.5).A total of 79 patients had an AUC>4 and 72 patients had an AUC<4.The mean relative dose intensities of pemetrexed were 101.4%for the AUC>4 group,and 100.4%for<4 group.Baseline characteristic variables were balanced between the two groups,except for Eastern Cooperative Oncology Group Performance score(p = 0.044).The overall response rate(ORR)and disease control rate(DCR)were 33.8%and 90.1%,respectively,35.4%and 86.1%for the AUC>4 group,and 31.9%and 94.4%for the AUC<4 group.No significant difference was observed in ORR(p = 0.650)and DCR(p = 0.086)between the two groups.Furthermore,analyses in both univariate and multivariate revealed that a higher AUC of carboplatin was not significantly associated with a higher ORR.Conclusion:Compared with an AUC of 5 or 6,the actual clinical application of AUC was generally insufficient for Chinese populations;fortunately,therapeutic efficacy remained equal.We found that AUC<4 was as adequate as AUC>4 in pemetrexed plus carboplatin regimen as first-line treatment for them.For patients with pretreated advanced non-small cell lung cancer(NSCLC),more effective treatments are unmet.We conducted a study to explore the optimal treatment schedule of nanoparticle albumin bound paclitaxel(Nab-PTX)as a second line or later treatment for advanced NSCLC patients in China.Ninety-eight patients,who had experienced failure of prior treatment and received Nab-PTX monotherapy(130 mg/m)on days 1,8 of a 21-day cycle were included.The median progression-free survival(PFS)and overall survival(OS)were 4.34 months(95%confidence interval[CI]3.508 to 5.165 months)and 11.73 months(95%CI 9.211 to 14.247 months),respectively.The objective responses rate(ORR)and disease control rate(DCR)were 22.4%and 74.5%.Prior treatment with taxane and line of therapy did not influence the efficacy of Nab-PTX.The main grade 3 to 4 toxicities were neutropenia(25.5%)and leukopenia(12.4%).Furthermore,24 cases offered samples to assess secreted protein acidic and rich in cysteine(SPARC)expression.No statistical difference was observed in treatment efficacy between SPARC expression-negative and positive.The findings suggest that weekly Nab-PTX monotherapy is effective and well tolerated for patients with pretreated advanced NSCLC,regardless of prior taxane exposure or line of therapy.