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A. Ramaswamy
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P3.02b - Poster Session with Presenters Present (ID 494)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02b-058 - Second-Line Therapy in EGFR Activating Mutation Positive Advanced NSCLC: Analysis from a Randomized Phase III First-Line Trial (ID 5591)
14:30 - 14:30 | Author(s): A. Ramaswamy
- Abstract
Background:
To evaluate the efficacy of second line therapy in patients progressing on either a Pemetrexed-Platinum doublet or Gefitinib in an epidermal growth factor receptor (EGFR) activating mutation positive Stage IIIB/IV non small cohort in the setting of a phase III clinical trial evaluating Pemetrexed-Platinum doublet versus Gefitinib as first line therapy
Methods:
Patients were part of a randomized Phase III open label parallel group study comparing Gefitinib with Pemetrexed- Platinum doublet in the upfront setting in an EGFR mutation positive Stage IIIB/IV lung cancer population. On progression on first-line therapy, patients were started on second line therapy, if Eastern Cooperative Oncology Group (ECOG) performance status (PS) was 0-2 and baseline clinical and biochemical parameters were within acceptable limits. Patients who received Pemetrexed-Platinum in the first line were offered Gefitinib in the second-line while patients progressing on first-line Gefitinib were considered for Pemetrexed-Platinum doublet as second-line therapy.
Results:
187 patients were included for analysis.Out of these 157 patients were evaluable for response. 113 patients had received gefitinib as second line ,while 74 patients had received other I.V second line chemotherapy. The response rate was 60.6% in Gefitinib cohort (60, n=99) and 31% in non -Gefitinib cohort (18, n=58), {p=0.30}. The median PFS was 7.4 months (95% CI:5.4-9.4) in gefitinib cohort, whereas it was 4.4 months in non -gefitinib cohort (95% CI:3.7 -5.2). Median OS in gefitinib cohort was 14 months (95% CI:10.8-17.2), while it was 9.8 months in non -gefitinib cohort (95% CI:7.8-11.7){p-0.007}
Conclusion:
Patients started on gefitinib post progression on pemetrexed therapy had significant benefit, whereas it was limited in patients who received I.V chemotherapy post Gefitinib.
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P3.02b-065 - Third Line Therapy in EGFR Positive Advanced Non-Small Cell Lung Cancer (ID 5629)
14:30 - 14:30 | Author(s): A. Ramaswamy
- Abstract
Background:
This study was designed to evaluate the response and outcomes to third line chemotherapy in classic activating EGFR mutation positive non small cell lung cancer (NSCLC) who had progressed on both TKI and intravenous chemotherapy
Methods:
85 EGFR mutation positive NSCLC patients who had received both TKI and intravenous chemotherapy(mainly Pemetrexed and platinum, 80 patients) were selected for this analysis. The treatment regimens, response in accordance with RECIST v1.1 and treatment outcomes were noted. Descriptive statistics was performed. Kaplan Meier survival analysis was used for estimation of PFS and OS.
Results:
85 patients received third line therapy of which weekly paclitaxel was given in 43(50.6%) patients, Docetaxel in 15(17.6%) patients, Gemcitabine in 6(7.1%) patients , rechallenged TKI in 11(13%) patients and other chemotherapy in 10(11.8%)patients. Out of 85 patients , 67 were evaluable for response; 13(19.4%) patients had partial response, 34(50.7%) patients had stable disease and 20(29.9%)patients had progression as best response. In 7 patients chemotherapy had to be stopped. It was because of toxicity in 5 patients and patients preference in 2 patients. The median PFS & OS were 4.2 months (95% CI 3.4-4.9 months) and 8.4 months (95% CI 6.9-9.9 months) respectively. There was no difference in PFS and OS between weekly Paclitaxel and other regimens.
Conclusion:
Third line therapy in EGFR mutated patients post TKI and Pemetrexed progression is associated with meaningful PFS and OS.
