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Y. Zhu
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P2.03a - Poster Session with Presenters Present (ID 464)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03a-019 - A Retrospective Analysis Of Nanoparticle Albumin Bound Paclitaxel In Chinese Patients With Recurrent Advanced Non-small Cell Lung Cancer In A Single Center (ID 4068)
14:30 - 14:30 | Author(s): Y. Zhu
- Abstract
Background:
This is the first report describing the safety and short-term efficacy of nanoparticle albumin bound paclitaxel (Nab-PTX) as monotherapy administered weekly in the treatment of Chinese patients with recurrent advanced non-small cell lung cancer (NSCLC), and analyzing potential factors that may affect prognosis.
Methods:
Patients with recurrent advanced NSCLC who received an weekly nab-paclitaxel regimen (130 mg/m2/week) treatment were eligible.Toxicity and response according to the RECIST criteria were summarized in the study. Classification and regression tree (CART) analysis was performed to estimate the effect of variables (age, gender, performance score, smoking, clinic stage, pathological type, previous line of therapy, treatment cycles, EGFR status, EGFR-/ALK-TKIs, SPARC expression) on PFS. The Kaplan–Meier analysis was used to estimate the effect of terminal tree notes.
Results:
A total of 104 patients were included in the study from June 2010 to March 2014 in the Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences,. The median follow-up period was 9.56 months (0.92-34.00 months). The overall response rate was 21.4%, and the disease control rate was 73.8%. The median PFS was 4.53 months (95% CI: 3.518- 5.542), and the median OS was 12.53 months (95% CI: 10.502- 14.558). Grade 3 adverse events were neutropenia (8.8%), peripheral neuropathy (4.8%), myalgia/arthralgia (4.0%), and fatigue (1.9%), respectively. Grade 4 toxicities rarely occured except neutropenia (1.0%). CART analysis identified 4 terminal nodes based on therapy cycles, age and therapy line. In the four subsets, those with ＜ 4 therapy cycles had the lowest PFS (Median: 1.80 months). Those with ≥ 4 cycles and age ≥70 years had the longest PFS (Median: 8.83 months). The median PFS was significantly different between the four subgroups (P =0.000). In addition, PFS in the ≥ 4 therapy cycles group was better than the without group (Median: 6.23 vs. 1.80 months, P=0.000). No PFS significant differences were observed for both age (≥70 years vs ＜70 years; Median: 8.83vs. 5.87 months, P=0.06) and lines of therapy (＞third-line vs ≤ third-line; Median: 6.37 vs 4.60, P=0.063). A trend of a benefit in PFS in favor of ≥70 years age and ＞third-line groups was found in our treatment.
Conclusion:
The weekly Nab-PTX regimen was effective and well-tolerated in patients with recurrent advanced NSCLC. Treatment cycles factors may be used to predict the therapeutic efficacy of Nab-PTX. Nab-PTX was also found the favourable survival benefit in older population (aged ≥70 years) and patients with ＞third-line therapy.
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P2.03a-068 - Impact of Platinum/Pemetrexed versus Other Platinum-Based Regimens on Adjuvant Chemotherapy in Resected Adenocarcinoma Lung Cancer (ID 4590)
14:30 - 14:30 | Author(s): Y. Zhu
- Abstract
Background:
Adjuvant chemotherapy improves the survival for completely resected non-small cell lung cancer (NSCLC) patients. Platinum/pemetrexed is known to be less toxicity, better compliance and longer survival in advanced non-squamous NSCLC, but the survival outcome compared with other regimens in adjuvant setting is still unknown. This report described the survival in adjuvant chemotherapy for lung adenocarcinoma with platinum/pemetrexed versus other platinum-based doublets.
Methods:
389 completely radical surgery lung adenocarcinoma patients who received adjuvant chemotherapy with platinum/pemetrexed regimen (Group A, n=143) and non-pemetrexed platinum-based regimens (Group B, n=246) were analyzed retrospectively. Primary end point was disease-free survival (DFS). Propensity score matching (PSM) allowed best matched pairs for platinum/pemetrexed versus other platinum-based doublets for comparison of survival and adverse events.
Results:
PSM created treatment groups for platinum/pemetrexed versus non-pemetrexed regimen (125 pairs), docetaxel and paclitaxel (107 pairs), gemcitabine (56 pairs), and vinorelbine (24 pairs)-contained doublets, respectively. Although DFS was not significantly different between Group A and B (P=0.1643)(Figure A), in 125 PSM pairs, DFS was considerably better in patients who received platinum/pemetrexed regimen (P=0.0079)(Figure B). From the subgroup analysis, Pemetrexed benefit is consistent across different subgroups, and especially aging(>65) was associated with the decision to use platinum/pemetrexed (HR=0.25,95%CI 0.09-0.73, P=0,011). Furthermore, platinum/pemetrexed was associated with several significantly lower hematological and non-hematological AE rates, such as versus gemcitabine (Leukopenia: RR 0.514, p=0.001; Neutropenia: RR 0.688, p=0.002) and paclitaxel- and docetaxel-based chemotherapy (Leukopenia： RR 0.685, p=0.019; Neutropenia: RR 0.805, p=0.032).Figure 1
Conclusion:
Adjuvant chemotherapy with platinum/pemetrexed shows both better disease-free survival and less clinical toxicity than other non-pemetrexed based doublets in completely resected adenocarcinoma lung cancer.
