Author of

• 10743

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

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10786

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    P1.10-043 - Doublet combination of platinum with pemetrexed for advanced non-small-cell lung cancer: a retrospective analysis of a single institution (ID 2425)

    09:30 - 09:30  |  Author(s): J.A. Núñez
    • Abstract

    Background
    There is no single standard doublet combination of platinum chemotherapy for non-small cell lung cancer (NSCLC). In non-inferiority phase III study, cisplatin/pemetrexed showed a significant improvement in survival in patients with non-squamous histology compare to cisplatin/gemcitabine. Recently, continuation maintenance with pemetrexed after cisplatin/pemetrexed was found to prolong overall survival as well. The objective of this retrospective study was to evaluate the efficacy of pemetrexed in combination with cisplatin or carboplatin for stage IV NSCLC at our institution

    Methods
    We reviewed the medical records of 103 patients with stage IV non squamous NSCLC (between January 2008 and December 2012) treated with pemetrexed in combination with platinum (cisplatin 75 mg/m2 or carboplatin AUC5 on day 1 plus pemetrexed 500 mg/m2 on day 1 every 3 weeks) at our institution. After induction chemotherapy patients received pemetrexed 500 mg/m2 every 3 weeks or best supportive care until disease progression or unacceptable toxicity

    Results
    From 103 patients, 27,2% were female and 72,8% were male. The ECOG was 0-1 in 80% of patients, and the median age was 63 years old. Smoking status was 39,5% current smokers, 48,9% former smokers, 10,4% never smokers and 1% unknown. Histologic type was 66% adenocarcinoma, 27% large-cell carcinoma and 7% non other. EGFR status was 46% wild type, 49% unknown and 5% mutated. The median cycles of doublet combination of platinum with pemetrexed was four cycles (1-8). 77,7% patients received carboplatin and 22,2% cisplatin. Thirty-three patients (32%) received maintenance therapy with pemetrexed. The median cycles of maintenance pemetrexed was four (1-34). The response rate achieved was 52,1% (Complete Response 4,4% + Partial Response 47,7%) and 21,1% stable disease, so 73,2% with clinical benefit. Median time to disease progression was 6,6 months (95% CI 4,8 to 7,6 months) in all patients. The median time to disease progression was 8,1 months (95% CI 5,9 to 9,9 months) in maintenance pemetrexed group and 4,1 months (95% CI 3,1 to 5,1 months) in best supportive care group (p<0,001). Median overall survival was 9,6 months (95% CI 8,1 to 11 months) in all patients. The median overall survival was 12,4 months (95% CI 10,4 to 17,1 months) in maintenance pemetrexed group and 9,1 months (95% CI 8,2 to 11,1 months) in best supportive care group (p=0,005)

    Conclusion
    Doublet combination of platinum with pemetrexed and maintenance pemetrexed is effective achieving good response rates and prolonging overall survival. The schema is feasible in patients with non-squamous NSCLC and we reproduced the data from clinical trials in our daily clinical practice. However, there are some questions remaining as the optimal number of induction cycles and most important which biomarkers factors are predicting benefit from maintenance chemotherapy