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

  • 10785

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    P1.10-042 - Chemotherapy in advanced non-small cell lung cancer patients previously treated with adjuvant chemotherapy (ID 2349)

    09:30 - 09:30  |  Author(s): M. Valdes
    • Abstract

    Background
    Adjuvant chemotherapy (CT) improves survival in patients (pts) with completely resected early stage NSCLC. Adjuvant cisplatin/vinorelbine (CV) is considered a standard of care in this population. However many pts relapse and require palliative CT, which may involve platinum doublet CT again. We investigated treatment choices on relapse after prior adjuvant CT, specifically in pts receiving palliative platinum doublet CT, and its impact on response rate (RR) and overall survival (OS).

    Methods
    With ethics approval, we performed a retrospective chart review of all pts with resected NSCLC who received adjuvant CT from January 2002 until December 2008 at our institution. Baseline pt demographics and cancer stage were recorded, along with treatment decisions upon relapse. The primary outcome was the RR to first-line palliative systemic therapy (ST).

    Results
    We identified 176 pts who received adjuvant platinum doublet CT (82% received CV). Patient characteristics were: median age 63 years (range 25-82); 55% female: median follow up 4.2 years: the primary surgical procedures were lobectomy (79%) or pneumonectomy (16%). The pathologic stage at surgery was 1A (2%), 1B (30%), 2A (7%), 2B (40%) and 3A (15%). In total 85 pts relapsed (48%), with a median time to relapse of 18.5 (95%CI 15-21.3) months. The variable most strongly associated with a shorter time to relapse was nodal stage (p=0.03); increasing T stage also demonstrated a trend towards shorter time to relapse (p=0.09). Of the 85 relapsed pts, 43 received palliative CT, and 42 received best supportive care (BSC) alone. Of the 43 pts treated, 25 (58%) were re-challenged with platinum doublet CT, with a RR of 28%, versus 17% (p=0.47) in 18 pts receiving other ST (most commonly docetaxel [n=7, 39%] or erlotinib [n=4, 22%). There was a trend towards increased clinical benefit rate (CR+PR+SD) in patients who were treated with a platinum doublet (67% versus 41% p=0.12). For all pts the median OS after relapse was 11.6 months. In pts receiving any CT (n=43), median OS was 15.3 months, compared to 7.8 months in those receiving BSC alone. Pts in the platinum-treated group had a longer survival after relapse than those pts treated with non-platinum regiments (18.4 versus 9.7 months, p=0.041). See Figure 1.Figure 1

    Conclusion
    In pts previously treated with adjuvant CT, re-treatment with platinum doublet CT upon relapse is feasible and associated with numerically higher response rates and significantly longer survival than those receiving other first-line ST.