Author of

• 10720

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  P1.09 - Poster Session 1 - Combined Modality (ID 212)

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

  • 10732

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    P1.09-012 - Pemetrexed as first-line treatment in combination with early radiotherapy in advanced non-squamous non-small cell lung cancer: a retrospective analysis (ID 1427)

    09:30 - 09:30  |  Author(s): Q. Zhang
    • Abstract

    Background
    Pemetrexed plus platinum recommended as first-line treatment for patients with advanced non-squamous non-small cell lung cancer (NSCLC) were more effective in East Asian patients. Few studies have evaluated the role of radiotherapy in combination with pemetrexed in advanced NSCLC. We hypothesized that pemetrexed plus platinum at full dose in combination with early radiotherapy can improve the clinical efficacy in advanced NSCLC, especially for selected patients.

    Methods
    Patients of stage IIIB or IV non-squamous NSCLC with unknown epidermal growth factor receptor (EGFR) mutation status were treated with pemetrexed plus platinum at full dose as first-line chemotherapy. All patients underwent concomitant chemoradiotherapy for primary cancer with or without radiotherapy for metastases. No patients had maintenance therapy with TKI after chemotherapy.

    Results
    Figure 1From January 2009 to July 2012, 43 patients were included, 21 of which were stage IIIB diseases (19 with stage N3- IIIB). In the 22 patients with stage IV disease, 17 had oligometastases (≤5) and 5 had polymetastases. The median chemotherapy cycles was 4.27 patients (62.8%) received ≥ 4 cycles of chemotherapy and 16 patients (37.2%) received <4 cycles. 36 patients (83.7%) received radical dose radiotherapy (≥60 Gy) and 7 patients (16.3%) received palliative dose to primary tumor. The median radiation dose was 60Gy. The median follow-up time of survival patients was 17.0months (range, 5.8 to 45.2 months). The median progression free survival (PFS) was 12 months. 12-, 18- and 24-months PFS rate were 50.4% （95%CI, 35.3-65.5%）, 25.1% (95%CI, 21-39.2%) and 21.5% (95%CI, 7.8-35.2%), respectively. 12-, 18- and 24-months overall survival (OS) rate were 90.1% (95%CI, 75.8-96.2%), 72.2% (95%CI, 54.2-84.1%) and 65.7% (95%CI, 44.3-80.5%), respectively. The median OS was not reached. Toxicities were better tolerated except one death of radiation-induced pneumonitis.

    Conclusion
    Pemetrexed plus platinum as first-line treatment in combination with early radiotherapy had encouraging short term efficacy with acceptable toxicity in selected patients with advanced NSCLC. Although the long-term efficacy needs further observation, the result showed potential advantage of early radiotherapy in Asian patients with advanced non-squamous NSCLC, especially stage IV.