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J.C. Cámara-Vicario
Author of
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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)
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P2.03a-023 - Induction-Maintenance Treatment Sequence in Non-Squamous Non-Small Cell Lung Cancer (neNSCLC): Pemetrexed vs Vinorelbine-Based Induction (ID 5795)
14:30 - 14:30 | Author(s): J.C. Cámara-Vicario
- Abstract
Background:
Non-squamous non-small cell lung cancer (neNSCLC) is the most frequent lung cancer subtype. Prognosis of advanced disease is poor, but in recent years, the treat-to-progression strategy has emerged, demonstrating significant improvement in overall survival (OS) of maintenance regimen with pemetrexed (Pem). There are limited head-to-head clinical trial data of various treat-to-progression strategies, and a Pem-based platin doublet induction strategy has never been directly compared to vinorelbine (VNR)-based one.
Methods:
We reviewed retrospectively patients diagnosed of advanced neNSCLC from 2006 to 2015 who were treated with Pem-based and VNR-based platinum doublet as induction chemotherapy, followed by Pem maintenance if they had not progressed. We evaluated clinicopathological features and clinical outcomes. The main objective was to assess if there were survival differences between both induction strategies in terms of progression free survival (PFS) and OS.
Results:
51 patients were reviewed, 74.5% men and 25.5% women. Mean diagnosis age was 64 (range 37-78). 15.7% never smoked and 84.3% had ever smoked. 70.6% received Pem-platin doublet and 29.4% VNR-platin doublet. Initial PS was 0 in 35%, 1 in 63%, 2 in 2%. In Pem group 69.4%. did not progress during induction and in VNR group 46.7%. 55,6% received maintenance Pem in Pem group and 33,3% in VNR group (p=0,08).More treatment delays were done in VNR doublet (53,3% vs 30,6%, p=0,047). Objective response rate (ORR) and disease control rate (DCR) were better with Pem-doublet. Pem: partial response (PR) 35.3%; stable disease (SD) 44.1%, disease progression (DP) 20.6%; VNR: PR 38.5%, SD 23.1%, DP 38.5%. Median PFS was slightly better in Pem group than in VNR one (6,2 vs 4,5 months; p=0,28) and median OS was also better with Pem (16,1 vs 11,2 months; p=0,39), but there were no significant statistical differences. More patients in VNR group needed hospitalization during induction (42,9 vs 25%; p=0,06). Most frequent adverse effects (AEs) were asthenia, anemia and neutropenia. Grade 3-4 asthenia, anemia and neutropenia were more frequent in VNR group.
Conclusion:
No big differences were found between both induction-maintenance strategies. Os and PFS were similar in both groups but Pem group presented a trend to better OS and PFS. More patients presented DP during induction treatment in VNR group. Pem group had better toxicity profile and less hospitalizations during treatment.
