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Background  The study was conducted to evaluate the efficacy and safety of weekly intravenous  n anoparticle albumin‐bound paclitaxel ( NAB ‐paclitaxel) treatment in patients with advanced non‐small‐cell lung cancer ( NSCLC ) who have undergone multi‐line therapy, and to investigate the association of secreted protein acidic and rich in cysteine ( SPARC ) expression status with clinical outcome.    Methods  Sixty‐four patients who received  NAB ‐paclitaxel treatment (130 mg/m 2  on days 1 and 8 of a 21 day cycle) as third line or further systemic treatment from 1  M ay 2011 to 30  J une 2014 were included in this retrospective analysis. Tumor tissue was available in 28 patients for analysis of  SPARC  expression by immunohistochemistry.    Results  Sixty‐two patients had response evaluation and complete survival follow‐up data; 83.9% received the weekly  NAB ‐paclitaxel as fourth‐line treatment or beyond. The objective response and disease control rates ( n  = 62) were 16.1% (10/62) and 64.5% (40/62), respectively. The median progression‐free and overall survival rates were 3.7 (95%  confidence interval  2.6–4.8) and 9.8 months (95%  confidence interval  6.9–12.8), respectively. Previous treatment with taxane did not affect the response to  NAB ‐paclitaxel. The main grade 3–4 toxicities experienced were neutropenia (9.4%) and leukopenia (7.8%). Patients with  SPARC  expression in tumor stroma but not in cancer cells had poorer progression‐free survival compared with those with negative  SPARC  expression in tumor stroma cells (3.3 vs. 5.0 months,  P  = 0.036).    Conclusion  Weekly  NAB ‐paclitaxel might be effective for heavily pretreated  NSCLC  patients.  SPARC  expression in tumor stroma cells might be a potential negative predictor of  NAB ‐paclitaxel.

thoracic cancer

Efficacy and safety of weekly intravenous nanoparticle albumin‐bound paclitaxel for non‐small cell lung cancer patients who have failed at least two prior systemic treatments