The efficacy and safety of albumin-bound paclitaxel plus carboplatin as neoadjuvant therapy for potentially resectable lung squamous cell carcinoma: a real-world retrospective cohort study

Wenjuan Jiang; Yuling Zhou; Liang Zeng; Yi Xiong; Li Liu; Chunhua Zhou; Haiyan Yang; Hui Guo; Fabrizio Minervini; Stefano Bongiolatti; Nong Yang; Yongchang Zhang; Min Tao

doi:10.21037/tlcr-22-252

The efficacy and safety of albumin-bound paclitaxel plus carboplatin as neoadjuvant therapy for potentially resectable lung squamous cell carcinoma: a real-world retrospective cohort study

Transl Lung Cancer Res. 2022 Apr;11(4):647-655. doi: 10.21037/tlcr-22-252.

Authors

Wenjuan Jiang^#^{1

2

3}, Yuling Zhou^#³, Liang Zeng³, Yi Xiong³, Li Liu³, Chunhua Zhou³, Haiyan Yang³, Hui Guo⁴, Fabrizio Minervini⁵, Stefano Bongiolatti⁶, Nong Yang³, Yongchang Zhang³, Min Tao^{1

2}

Affiliations

¹ Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.
² Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China.
³ Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
⁴ Department of Pathology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
⁵ Department of Thoracic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.
⁶ Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy.

^# Contributed equally.

Abstract

Background: In early and locally advanced stage non-small-cell lung cancer (NSCLC), surgery is the cornerstone of curative-intent treatments. And the addition of neoadjuvant or adjuvant chemotherapy can prolong overall survival (OS), albumin-bound paclitaxel plus carboplatin (ab-PC) as neoadjuvant therapy (NAT) has showed favorable effect for resectable lung squamous cell carcinoma (LSCC) with IIIA. However, to date, no study has investigated the efficacy of ab-PC as neoadjuvant chemotherapy in potentially resectable LSCC with IIIA-IIIB. This study aimed to evaluate the efficacy and safety of the regimen in potentially resectable LSCC.

Methods: Enrolled patients with stage IIIA and IIIB potentially resectable LSCC treated with neoadjuvant albumin-bound paclitaxel (nab-P; 100 mg/m², days 1, 8, and 15) and carboplatin (6 mg/mL/min, day 1) for two 21-day cycles at the Hunan Cancer Hospital between December 2017 and December 2019. The primary endpoint was the surgery conversion rate (SCR). Secondary endpoints included objective response rate (ORR), margin-free (R0) resection, major pathological response (mPR), and safety.

Results: In total, 49 patients were included in the study, with an overall response rate (ORR) of 67% (33/49). The SCR was 67% (33/49). Only 31 patients underwent surgery eventually, and R0 resection was achieved in 30 patients. Further, 4 (13%) and 11 (35%) of the 31 patients had a pathological complete response (pCR) and mPR, respectively. In total, 23 patients experienced treatment-related adverse events (TRAEs). The most common TRAE was liver disfunction (9 patients, 18%). Only 1 patient (2%) experienced a grade ≥3 TRAE of leukopenia. There were no treatment-related deaths or treatment discontinuations.

Conclusions: In this study, we found a high SCR (67%) and mPR (35%) after ab-PC treatment for stage IIIA and IIIB potentially resectable LSCC. ab-PC maybe considered a neoadjuvant chemotherapy option for potentially resectable LSCC patients.

Keywords: Potentially resectable lung squamous cell carcinoma (potentially resectable LSCC); carboplatin; neoadjuvant albumin-bound paclitaxel (nab-P); neoadjuvant chemotherapy; pathological response.