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I.K. Hwang
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P2.03 - Chemotherapy/Targeted Therapy (ID 704)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.03-020 - Pemetrexed Continuation Maintenance versus Conventional Platinum-based Doublet Chemotherapy in EGFR-negative Lung Adenocarcinoma: Retrospective Analysis (ID 8645)
09:30 - 09:30 | Author(s): I.K. Hwang
- Abstract
Background:
Although targeted therapy and immuno-oncology have shifted paradigm in treating lung cancer, platinum-based combination is still the standard of care for advanced lung cancer patients, especially for those without epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase translocation. Based on the JMDB study conducted by Scagliotti et al., pemetrexed/platinum combination is a preferred treatment for nonsquamous non-small cell lung cancer (NSCLC). However, which chemotherapeutic regimen is better for patients with EGFR-negative nonsquamous NSCLC remains unclear. Thus, the object of this study was to compare pemetrexed-based chemotherapy to non-pemetrexed-based chemotherapy for EGFR-negative advanced nonsquamous NSCLC.
Method:
A total of 183 patients with EGFR-negative nonsquamous NSCLC who were treated with platinum-based doublet between January 2009 and December 2016 were retrospectively enrolled for this study. Progression-free survival (PFS) and overall survival (OS) of different treatment regimens were analyzed and compared.
Result:
Drugs combined with platinum as first-line chemotherapy were as follows: pemetrexed (n = 97, 53%), gemcitabine (n = 52, 28%), paclitaxel (n = 24, 13%), and docetaxel (n = 10, 6%). Among 97 patients in the pemetrexed group, 50 (52%) received continuation maintenance chemotherapy with pemetrexed after 4 cycles of combination. In the non-pemetrexed group, 7 (8%) patients received switch maintenance chemotherapy with erlotinib (n = 5) or pemetrexed (n = 2). Median PFS and OS of all patients were 5.1 months (95% confidence interval [CI]: 3.8-5.9 months) and 15.3 months (95% CI: 8.9-18.4 months), respectively. Median PFS was significantly higher in the pemetrexed group compared to that in the non-pemetrexed group (7.2 vs 4.1 months, p < 0.05). In addition, median OS showed an increasing tendency in the pemetrexed group compared to that in the non-pemetrexed group but it was not statistically significant (19.5 vs 14.3 months, p = 0.06). Multivariate analyses showed that the use of pemetrexed-based regimen was independently associated with better PFS, but not with better OS.
Conclusion:
Although sample size was relatively small, our data suggest that pemetrexed-based treatment was more beneficial compared to non-pemetrexed based treatment for EGFR-negative advanced nonsquamous NSCLC. Further large-scale studies are needed to confirm our findings.
