• In this Phase III trial for patients with Stage IIIB or IV untreated NSCLC and renal impairment, ORR, PFS and OS improved nonsignificantly in favor of nab paclitaxel/carboplatin compared to solvent-bound paclitaxel/carboplatin with an increasing degree of renal impairment.
• Nab paclitaxel/carboplatin resulted in lower rates of Grade ≥3 neutropenia and sensory neuropathy but higher rates of Grade ≥3 thrombocytopenia and anemia.

A large global Phase III first-line study in NSCLC with both squamous and nonsquamous histologies evaluated carboplatin with either solvent-based paclitaxel or nab paclitaxel, and the resulting improvement in response rate led to the approval of nab paclitaxel in lung cancer. Although the approval was in both squamous and nonsquamous disease, a subset analysis revealed that most of the benefit was observed in patients with squamous histology. This publication further dissected the data from this important trial with regard to renal function and found that the combination of nab paclitaxel and carboplatin was well tolerated and effective in patients with and without renal impairment. Dr Spigel and other investigators use nab paclitaxel for select patients with squamous lung cancer, and the drug is also currently being studied in the maintenance setting.