Virtual Library
Start Your Search
J. Macklis
Author of
-
+
P2.03a - Poster Session with Presenters Present (ID 464)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
-
+
P2.03a-006 - Frequency of 2 Year PFS Milestone in Stage IV NSCLC Patients Treated with First Line Pemetrexed/Platinum and Pemetrexed Maintenance (ID 6288)
14:30 - 14:30 | Author(s): J. Macklis
- Abstract
Background:
Focusing on median progression free and overall survival does not fully inform us, or our patients, of the maximum achievable benefit found at the tail end of the survival curve (Hellman M, JAMA Oncology 2016). Milestone metrics in this context may be more informative; however, mature data are scarce. Our anecdotal observations suggested that some of our non-squamous NSCLC pts treated with pemetrexed continuation maintenance had long-term disease control beyond the reported median PFS. The objective of our single institution retrospective study was to determine the % of patients who reach the 2 year PFS milestone in patients whose treatment plan included continuation pemetrexed maintenance. Evaluation of the potential predictive value of clinical parameters was a secondary objective.
Methods:
Pts with stage IV NSCLC who received at least once cycle of pemetrexed/platinum with planned pemetrexed maintenance (N = 241) between May 2010 and December, 2013 were included in this retrospective analysis. Minimum follow up for every patient was > 24 months. Patient demographics, routine laboratory values, first and last dates of pemetrexed therapy, and date of progression were collected. Pts were grouped according to duration of disease control ≥24 months vs < 24 months. Potential associations between patient demographics and comparison of laboratory values for the two groups were assessed using a Mann-Whitney-Wilcoxon test.
Results:
Median age 66, male/female 40.25%/59.75%, 21% never smoker. The median progression free survival was 6.2 months. 34 pts (14.1%) had no progression of disease at ≥24 months since starting treatment with pemetrexed/platinum followed by pemetrexed maintenance. A PFS ≥24 months was associated with a lower baseline neutrophil/lymphocyte ratio (NLR) (median 3.3 vs 4.55; 25-75 percentile 2.32-3.94 vs 2.8-7.89; p=0.0011). PS at baseline was also significantly associated with a PFS≥24 months (p=0.02). Long term PFS was not significantly related to gender, age, sites of metastases, or number of disease sites.
Conclusion:
Considering that the two year OS rate for first line chemotherapy in clinical trials is approximately 25%, the 2 year PFS milestone rate of 14.1% patients is encouraging. Significantly lower baseline NLR, was observed in patients who reached the two year PFS milestone. Studies evaluating the potential predictive value of other clinical and molecular parameters are ongoing.
