Weiss JM, Pennell N, Deal AM, et al. - Since there exists a controversy regarding the selection of later-line therapy for older patients with AJCC (version 7) stage IV non–small cell lung cancer (NSCLC), and approval has been granted to nanoparticle albumin–bound (nab)-paclitaxel with carboplatin for the first-line treatment of patients with NSCLC, and superior survival in older patients has been reported in subgroup analysis of phase 3 data, so, researchers assessed grade 3 to 5 toxicity (according to the National Cancer Institute Common Terminology Criteria for Adverse Events [version 4.0]) among 42 patients aged ≥ 70 years who had already received a platinum doublet regimen (patients also could have received a PD-1 inhibitor). In this phase 2 study of nab-paclitaxel, the rate of grade 3 to 5 toxicities was estimated to be 33.7%. The response rate, median progression-free survival (PFS), and median overall survival (OS) were estimated to be 34.2%, 5.2 months and 9.3 months, respectively. Frailty and prefrailty were seen in 42% and 39% of patients, respectively, whereas an Eastern Cooperative Oncology Group performance status of 2 was present in 21% and 27% were sarcopenic. Inferior survival was predicted only by frailty. In a subgroup analysis including 19 older patients managed with nab-paclitaxel alone in a previous trial, the estimated response rate, PFS, and OS were 15.8%, 4.2 months, and 13.6 months, respectively. Based on these findings, experts recommended considering fit and prefrail older patients having stage IV NSCLC for management with nab-paclitaxel following disease progression with doublet chemotherapy.