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L. Ramírez-Tirado
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P2.03b - Poster Session with Presenters Present (ID 465)
- 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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P2.03b-088 - PET-CT with 68Ga-RGD as Biomarker of Response to Nintedanib plus Docetaxel as Second Line Therapy in NSCLC (ID 5196)
14:30 - 14:30 | Author(s): L. Ramírez-Tirado
- Abstract
Background:
Nintedanib, an approved second-line treatment for NSCLC in combination with docetaxel, is an oral angiokinase inhibitor against pro-angiogenic pathways. Advanced techniques in nuclear medicine have developed new radiotracers, such as Ga68-RGD for assessment of tumor vascularity and therapy response. The αVβ3 integrin is a transmembrane protein of great importance in tumor angiogenesis, due to its massive overexpression. Peptides containing the RGD sequence have high affinity for αVβ3 integrin receptors overexpressed in tumor cells. We evaluate objective-response rate (ORR), disease-control rate (DCR) by RECIST v.1.1, progression-free survival benefit (PFS) and overall survival (OS) obtained by Nintedanib plus Docetaxel therapy, and its response measured by PET-CT with Ga68-RGD biomarker.
Methods:
Study enrollment from July 2014 to October 2015. Inclusion criteria were confirmed adenocarcinoma histology, and disease progression after platinum-based-chemotherapy. Thirty-eight patients were assigned to receive Docetaxel (75mg/m2, IV) on day 1 plus Nintedanib (200mg, orally twice daily) on days 2-21 every three weeks until unacceptable adverse events or disease progression. All patients underwent a PET-CT with IV tracer Ga68-RGD and measurements at three time points (30, 60 and 120 mins) prior treatment start and after completing 2 therapy cycles.
Results:
Mean age at diagnosis was 58.7±11.4 years. Of the 38 patients, 31 had complete data for analysis. After 2 treatment cycles, the PET-CT assessment response, based on baseline Lung/Spleen SUVmax index, showed an ORR of 7.9% and DCR of 47.3%. Median PFS of 3.7 months and median Hypertensive patients were more likely to have a higher PFS (6.3 vs. 3.3 months; p=0.023), as well as patients with a larger baseline tumoral-volume by Ga68-RGD PET-CT (2.1 vs. 6.1 months; p=0.007). Global OS was of 8.8 months. Non-smokers were more likely to have larger OS (9.3 vs 4.2; p=0.008). Also a median OS was longer among patients with higher Lung/Spleen SUVmax index percentage change after treatment (9.4 vs. 4.9 months; p=0.05) was found.
Conclusion:
A larger baseline tumoral-volume can be associated to a higher progression-free survival due to the major cellular component to target with antiangiogenic therapy, as well as a strong association of larger survival assessed by the Lung/Spleen SUVmax index after treatment, marked by the Ga68-RGD radiotracer.
