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

  • 10766

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    P1.10-023 - Favorable response to EGFR-TKI is a predictive marker of taxane activity, but not of pemetrexed in patients with non-squamous non-small cell lung cancer (ID 1412)

    09:30 - 09:30  |  Author(s): J.H. Kim
    • Abstract

    Background
    Both taxane and pemetrexed have significant activities as salvage chemotherapeutic agents in non-squamous non-small cell lung cancer (NSCLC). The purpose of this study was to compare the efficacy of taxane and pemetrexed according to EGFR activating mutation status in patients with advanced non-squamous NSCLC.

    Methods
    This retrospective analysis included patients with stage IIIA-IV non-squamous NSCLC given both taxane and pemetrexed in their clinical courses regardless of treatment line. Patients were dichotomized into favorable or unfavorable EGFR-tyrosine kinase inhibitor (TKI) response group. Favorable response group was defined as harboring EGFR activating mutation or partial remission and progression-free survival (PFS) ≥ 4 months with EGFR-TKI.

    Results
    62 patients were eligible for analysis (24 of favorable and 38 of unfavorable EGFR-TKI response group). Response rate (RR) of taxane based regimen was 37.5% vs. 28.9% (p=0.483) and disease control rate (DCR) was 79.2% vs. 55.3% (p=0.055) in favorable and unfavorable EGFR-TKI response group, respectively. RR of pemetrexed based regimen was 12.5% vs. 34.2% (p=0.057) and DCR was 66.7% vs. 76.8% (p=0.407) in favorable and unfavorable group, respectively. PFS with taxane based regimen was 5.5 months (95% CI 5.0-6.0) vs. 2.6 months (95% CI 1.4-3.8) in favorable and unfavorable group, respectively (p=0.006). PFS with pemetrexed based regimen was 4.1 months (95% CI 2.9-5.3) vs. 4.6 months (95% CI 1.9-7.2) in favorable and unfavorable group, respectively (p=0.361). PFS with taxane vs. pemetrexed based regimen was 5.5 vs. 4.1 months in favorable EGFR-TKI response group (p=0.027), and 2.6 vs. 4.6 months in unfavorable EGFR-TKI response group (p=0.112). The adjusted HR for disease progression of taxane based regimen in favorable EGFR-TKI response group compared with unfavorable group was 0.455 (95% CI 0.252-0.819; p=0.009) in multivariate Cox-regression analysis. However, PFS with pemetrexed based regimen was not associated with EGFR-TKI responsiveness (HR 1.014, 95% CI 0.547-0.877; p=0.966). The overall survival of favorable group vs. unfavorable EGFR-TKI response group was 45.4 vs. 22.8 months (p<0.001).

    Conclusion
    Favorable response to EGFR-TKI is a predictive marker of taxane activity, but not of pemetrexed in patients with non-squamous NSCLC. Taxane would be the first consideration for patients with disease progression after durable response to EGFR-TKI.