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Y. Takeuchi



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    P1.10 - Poster Session 1 - Chemotherapy (ID 204)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.10-015 - Phase II study of pemetrexed plus intermittent erlotinib combination therapy for pretreated advanced non-squamous non-small cell lung cancer with documentation of epidermal growth factor receptor mutation status (ID 959)

      09:30 - 09:30  |  Author(s): Y. Takeuchi

      • Abstract

      Background
      Erlotinib and pemetrexed are recommended for the second-line treatment of non-small cell lung cancer (NSCLC). With the recommended doses determined by our previous phase I study [BMC Cancer 2012;12(1):296], we conducted a phase II study to evaluate the efficacy and safety of combination of the two agents in patients with pretreated non-squamous NSCLC.Erlotinib and pemetrexed are recommended for the second-line treatment of non-small cell lung cancer (NSCLC). With the recommended doses determined by our previous phase I study [BMC Cancer 2012;12(1):296], we conducted a phase II study to evaluate the efficacy and safety of combination of the two agents in patients with pretreated non-squamous NSCLC.

      Methods
      Patients with stage III/IV or post-surgically recurrent non-squamous NSCLC whose disease had progressed after first-line chemotherapy were enrolled. Patients received 500 mg/m[2] of intravenous pemetrexed every 21 days and 150 mg of oral erlotinib on days 2–16 until disease progression or unacceptable toxicity. The primary objective was the response rate (RR). The secondary objectives were the disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and safety.

      Results
      A total of 27 patients, 16 males and 11 females, with the median age of 70 (range, 48–80) were enrolled. They included 21 stage IV diseases and 22 adenocarcinomas. The Epidermal growth factor receptor (EGFR) gene mutations were examined in all patients and only one patient was positive. The median number of treatment courses was 3 (range, 1 to over 19). The RR and DCR were 11.1% and 63.0%. The median PFS and OS were 2.8 months (95% confidence interval (CI); 1.9 to 7.5) and 15.8 months (95% CI; 9.3 to not available), respectively. As for safety, dermal, hepatic, gastrointestinal and hematological disorders were the frequently observed adverse events. Grade 3/4 toxicities observed in more than 15% patients were neutropenia (n = 10), anemia (n = 6), febrile neutropenia (n = 6), ande anorexia (n = 5). One patient experienced grade 3 drug-induced interstitial lung disease.

      Conclusion
      We could not demonstrate the add-on effect of intermittent erlotinib on pemetrexed in the second-line treatment of non-squamous NSCLC without EGFR mutations.