Author of

• 11692

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  P2.10 - Poster Session 2 - Chemotherapy (ID 207)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11706

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    P2.10-014 - A phase II study of bevacizumab in combination with carboplatin and paclitaxel in patients with non-squamous (Non-Sq) non-small-cell lung cancer (NSCLC) harboring Mutations of Epidermal Growth Factor Receptor (EGFR) gene after failing First-line EGFR-Tyrosine Kinase Inhibitors (TKIs) Hanshin Oncology Group 0109 (ID 1054)

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

    Background
    EGFR-TKIs’ mono-therapy is one of the standard 1[st] line therapy for NSCLC harboring EGFR gene mutations. Although platinum doublet ± bevacizumab recommended for 2nd line therapy after failing EGFR-TKIs in National Comprehensive Cancer Network guideline, there is little information of these setting. Therefore, we planned prospective phaseⅡ study to evaluate the efficacy and safety of bevacizumab in combination with carboplatin and paclitaxel(PCB) for EGFR-TKIs resistant Non-Sq NSCLC.

    Methods
    In multicenter phase II trial, we recruited non-squamous NSCLC harboring EGFR gene mutation after failing EGFR-TKIs. Key eligibility criteria were as follows: Non-Sq NSCLC with EGFR mutation, failure of 1[st] line EGFR-TKIs, stageIIIB or IV or recurrence after surgery, measurable lesion, age 20 or over, ECOG Performance status (PS) 0 or 1, adequate organ function. Clinically significant hemoptysis, symptomatic brain metastasis, uncontrollable hypertension, interstitial pneumonia were excluded. Patients received carboplatin (AUC=6/5), paclitaxel (200mg/m2), bevacizumab (15mg/kg) intravenously on day1 every 3 weeks for three to six cycles, and bevacizumab was administered every 3 weeks until disease progression or intolerable toxic effects. Primary endpoint was response rate (RR) and secondary endpoints were progression free survival (PFS), overall survival (OS), disease control rate (DCR) and safety.

    Results
    A total of 31 patients were assigned between March 2010 and February 2013. One patient was excluded because of unfitted eligibility criteria. Therefore, we analyzed thirty patients’ data. Median age was 60 years (45~74), male/female : 11/19, PS 0/1 : 9/21, non-smoker/smoker : 18/12, EGFR mutation status exon19 del/exon21 L858R : 20/11, 1[st] line EGFR-TKIs gefitinib/erlotinib/other : 22/7/1. RR : 40% (95%CI:22%-58%), DCR : 83% (95%CI:70%-97%), PFS : 6.0 month (95%CI:4.8-12.2). Major severe adverse event (Grade 3,4) were one patient with dyspnea (G4), 6 with fever neutropenia (G3) and 3 patients with hyper tension (G3). There was no grade 5 adverse event.

    Conclusion
    In patients with Non-Sq NSCLC harboring EGFR gene mutation failed 1[st] line EGFR-TKIs, RR of 2[nd] line PCB therapy was lower than it was in 1[st ]line phase II study of PCB in Japan, but same RR of E4599 study. Safety was similar to previous reports. We considered PCB therapy is one of the treatment option in 2[nd]-line for patient with EGFR-TKIs resistant Non-Sq NSCLC.