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W. Shen
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P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.02-033 - Pemetrexed plus Platinum as Adjuvant Therapy in Patients with Resected Lung Adenocarcinoma and Exploratory Biomarkers Analysis (ID 2524)
09:30 - 09:30 | Author(s): W. Shen
- Abstract
Background:
Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death around the world. Currently, adjuvant platinum-based chemotherapy is recommended as the standard treatment for patients with completely resected stage IB-IIIA NSCLC. Pemetrexed, a multitargeted antifolate agent, has been shown to have definite activity in non-squamous NSCLC and has proven to be efficacious in the first-line metastatic NSCLC. Hence, the aim of this study was to evaluate the efficacy and toxicity of pemetrexed/ platinum in patients with completely resected lung adenocarcinoma and identify prognostic factors in this setting.
Methods:
A retrospective study was performed in patients with completely resected stage IB-IIIA lung adenocarcinoma who received pemetrexed and a platinum as adjuvant therapy. Generally, pemetrexed 500mg/m2 d1 and cisplatin 30mg/ m2 day1-3 were administrated every 21-28 days for 4 cycles. Study endpoints included overall survival (OS), progression-free survival (PFS) and treated-related toxicities. Immunohistochemical (IHC) was used to examine the protein expression of p53, thymidylate synthase (TS), dihydrofolate reductase (DHFR), Lipocalin 2 and nm23-H1 in surgical resection specimens of 23 patients. The associations between protein expression level and clinical outcome were evaluated using cox proportional hazards model.
Results:
Between Feb. 2012 and Jan.2014, 49 patients were treated with pemetrexed-based chemotherapy. Median age 57(range35-79, years), males 47%; stage IB 41%, II 18%, IIIA 41%; ever smokers 35%; lobectomy 92%, wedge resection 8%. The completion of 4-cycle chemotherapy was 67.3%. Grade 3+ hematologic and gastrointestinal toxicities were observed in 5 (10%) patients and 4 (8%) patients, respectively. The median PFS was 39.63 months (95%CI 26.55-52.71 months), and the median OS was unreachable. 1-, 2- and 3-year survival rates were 95.9%, 93.6%, 83.2%, respectively. 1-, 2- and 3-year PFS rates were 93.9%, 75.3% and 56.8%, respectively. Of 23 patients measured by IHC, 19 expressed TS, 9 expressed p53, 10 expressed DHFR, and none expressed Lipocalin 2 or nm23-H1. No significant correlations of these protein expression and clinical outcome were observed.
Conclusion:
The regimen of pemetrexed/platinum showed lower incidence rates of toxicities and promising treatment outcomes in patients with completely resected stage IB-IIIA lung adenocarcinoma. However,no prognostic biomarker was identified in our study, which may be related to the small sample size.
