Albumin-Bound Paclitaxel and Gemcitabine in Patients With Untreated Stage IV or Recurrent Squamous Cell Lung Cancers

A Phase II Trial of Albumin-Bound Paclitaxel and Gemcitabine in Patients With Untreated Stage IV or Recurrent Squamous Cell Lung Cancers

The purpose of this study is to test the safety and effectiveness of albumin-bound paclitaxel plus gemcitabine in patients with advanced squamous cell lung cancers. The investigators would like to determine the percentage of patients with squamous cell lung cancers who experience shrinkage of their tumors following treatment with this regimen. This combination of drugs is not a standard therapy for patients with squamous cell lung cancers. However, each of these drugs, when given alone or with other chemotherapies, is FDA-approved for the treatment of this disease.

Inclusion Criteria:

• Histologically confirmed squamous cell lung cancer
• Newly diagnosed untreated Stage IV and/or recurrent after adjuvant therapy with metastatic disease
• Patients previously treated with immune checkpoint inhibitor therapy are eligible
• Measurable disease as per RECIST 1.1
• Greater than 6 months since receiving neo-adjuvant or adjuvant chemotherapy.
• Age ≥ 18 years
• Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
• Women of childbearing potential and sexually active men enrolled in the study must agree to practice effective contraception method during treatment and for three months after completing treatment
• Negative serum or urine β-hCG pregnancy test at screening for patients of childbearing potential
• < Grade 2 pre-existing peripheral neuropathy (per CTCAE)
• Marrow and organ function as follows:
• ANC ≥ 1500 cells/mm3
• Platelets > 100,000 cells/mm3
• Hemoglobin>9g/dL
• Creatinine clearance ≥ 40mL/min
• Bilirubin ≤ 1.5 mg/dL
• AST/ALT≤2.5 x upper limit of normal range (ULN),
• alkaline phosphatase ≤ 2.5 X upper limit of normal, unless bone metastasis in present in the absence of liver metastasis

Exclusion Criteria:

• Prior treatment with albumin-bound paclitaxel or gemcitabine
• Prior systemic anticancer therapy for advanced squamous cell lung cancer
• Untreated brain metastasis. Patients with treated brain metastases who are off steroids are eligible
• Peripheral neuropathy greater than grade 1
• Malignancies within the past 5 years other than non-melanoma skin cancer or insitu cervical cancer status post treatment
• Patients with other serious medical illnesses including, ongoing or active infection, unstable angina pectoris, or psychiatric illness/social situations that would limit compliance with study requirements
• Class III or IV congestive heart failure by New York Heart Association