Efficacy and Safety of Paclitaxel/nab-paclitaxel Chemotherapy for Patients With Relapsed Small Cell Lung Cancer

Background/Aim: Systemic chemotherapy is effective for patients with untreated advanced small cell lung cancer (SCLC); however, most patients eventually experience recurrence. Therefore, development of novel beneficial and tolerable treatments for patients with relapsed SCLC is important. Patients and Methods: In this retrospective observational study, we analyzed patients with relapsed SCLC who were treated with paclitaxel (PTX) or nab-paclitaxel (nab-PTX) at five institutions in Japan between April 2015 and September 2020. The relationships between the outcomes of PTX or nab-PTX and patient characteristics were examined. Results: A total of 31 patients with SCLC treated with PTX or nab-PTX were enrolled. The response rate and disease control rate (DCR) were 9.7% and 67.7%, respectively. The median time-to-treatment failure (TTF) was 69.0 days (95% confidence interval=39.0-97.0). In multivariate analysis, TTF showed a significant difference in serum albumin level (>= 3.6 g/dl) and platelet-to-lymphocyte ratio (>= 250). Adverse events of any grade and grade >= 3 occurred in 23 (74.2%) and 15 (48.4%) patients, respectively. Among patients with grade >= 3 adverse events, hematological and non-hematological toxicities occurred in 12 (38.7%) and 6 (19.4%) patients, respectively. No treatment-related deaths were observed. Seven patients with interstitial lung disease were included in the study, and the efficacy and safety of treatment were equivalent to those of other patients. Conclusion: Treatment with PTX or nab-PTX is effective and tolerable for patients with relapsed SCLC, including those with interstitial lung disease. Our observations suggest that pretreatment inflammatory and nutritional indices may be useful biomarkers for treatment with PTX or nab-PTX.