Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
Background: Scc accounts for about 30-40% of lung cancer cases, and the
majority presents with locally advanced or metastatic disease. Vinorelbine/
carboplatin (VC) and gemcitabine/carboplatin (GC) are both third-generation
combinations used in the treatment of NSCLC. VC and GC were similar with
respect to efficacy, healthrelated quality of life (HRQOL) and toxicity in
stage IIIB/IV NSCLC patients.The aim is to compare VC and GC with respect to
efficacy, DFS, hematologic toxicity in stage IIIB/IV Scc lung cancer patients.
Methods: Chemonaive patients with SCC lung cancer stage IIIB/IV and
WHO performance status 0–2 were eligible. No upper age limit was defined.
Patients received vinorelbine 25 mg m 2 or gemcitabine 1000 mg m 2 on days
1 and 8 and carboplatin AUC 4 on day 1 and six courses with 3-week cycles.
During 13 months, 103 patients were included (VC, n=53; GC, n=50). Results:
median DFS was 22 vs 24.5 weeks (p=0.42 ), ORR (3cycle) 49.05% vs 58%
and ORR(6cycle) % 16.89 vs %16 in the VC and GC arm, respectively (P=0.48).
nausea/vomiting showed no significant differences. More grade 3–4 anemia
(P=0.009), thrombocytopenia (P = 0.004) in GC arm . There was more grade 3–4
leucopoenia (P=0.28) in the VC arm, but the rate of neutropenic infections was
the same (P=0.87). Conclusion: VC and GC are similar in treating advanced SCC
lung cancer when regarding ORR and DFS, while grade 3–4 toxicity requiring
interventions were less frequent when VC is compared to GC in advanced
squamous cell lung cancer.
Keywords: GC, VC, First Line, Advanced squamous lung cancer
POSTER SESSION 2 – P2.03A: ADVANCED NSCLC & CHEMOTHERAPY/TARGETED THERAPY/
IMMUNOTHERAPY
CLINICAL TRIALS –
TUESDAY, DECEMBER 6, 2016
P2.03A-022 QOL AND FEBRILE NEUTROPENIA: JAPANESE PHASE 2
TRIAL OF DOCETAXEL WITH/OUT ANTIANGIOGENIC AGENT IN 2ND
LINE NSCLC
Yukie Omori 1 , Alan Brnabic 2 , Narayan Rajan 2 , Jangchul Park 1 , Sotaro Enatsu 1 ,
Akira Inoue 3
1 Eli Lilly Japan K.K., Kobe/Japan, 2 Eli Lilly Australia Pty. Limited, West Ryde/NSW/
Australia, 3 Tohoku University, Sendai/Japan
Background: Febrile neutropenia (FN) is one of the serious complications
associated with cancer chemotherapy and often leads to dose reduction and
change of administration schedule which may affect treatment outcomes.
This post hoc analysis explored the association between FN and patient
reported outcomes (PRO). Methods: PROs were collected in the trial JVCG with
Lung Cancer Symptom Scale (LCSS) and EQ-5D-3L. LCSS includes 6 symptom
questions (loss of appetite, fatigue, cough, dyspnea, hemoptysis, pain)
and 3 global QOL items (symptom distress, difficulties with daily activities,
QOL) measured on a 0-100 mm scale, with higher scores representing greater
symptom burden. PROs were collected at baseline (BL, during 14days till
randomization), around Day 21 in every cycle, at the timing of discontinuation
and at 30-day follow up (FU). LCSS total score, global QOL total score, each
global QOL item score, EQ-5D utility index and VAS score were calculated.
Time to deterioration (TtD) of the LCSS and EQ-5D defined as increase from
BL by ≥15 mm for LCSS and ≥15% drop for EQ-5D, respectively, was analysed
using the Kaplan-Meier method stratified by treatment-emergent FN status.
Results: Of 192 patients randomized to receive ramucirumab+docetaxel
or placebo+docetaxel, 80.0% were male, median age was 64.6 and 54.0%
had performance status1 at BL. FN occurred in 26.0% (50/192). Patients
compliance with LCSS and EQ-5D were approximately 97.4% and 97.9%,
respectively. Patients without FN showed longer TtD than patients with FN
in LCSS total score and EQ-5D VAS score. Hazard ratio (HR) (95% CI) for LCSS
total score were 0.731 (0.469, 1.141), p=0.0945 (stratified) with censoring
rate of 44.0% (with FN) and 54.9% (without FN). For EQ-5D VAS score, HR
were 0.802 (0.537, 1.199), p=0.5956 with censoring rate of 32.0% (with FN)
and 43.0% (without FN). No significant difference was found. Conclusion:
Prevailing clinical opinion suggests that FN negatively impacts QOL. In trial
JVCG, a tendency was shown that QOL of patients with FN deteriorates
more rapidly than in patients without FN, consistent with current beliefs.
Additional investigation is needed but prevention and management of FN
may contribute to maintaining QOL.
Keywords: Targeted therapy, antiangiogenesis, advanced NSCLC, Patient
reported outcomes (PRO)
POSTER SESSION 2 – P2.03A: ADVANCED NSCLC & CHEMOTHERAPY/TARGETED THERAPY/
IMMUNOTHERAPY
CLINICAL TRIALS –
TUESDAY, DECEMBER 6, 2016
P2.03A-023 INDUCTION-MAINTENANCE TREATMENT SEQUENCE
IN NON-SQUAMOUS NON-SMALL CELL LUNG CANCER (NENSCLC):
PEMETREXED VS VINORELBINE-BASED INDUCTION
Xabier Mielgo Rubio 1 , Ruth Martínez-Cabañes 2 , Clara Olier-Garate 1 , Jorge
Silva-Ruiz 1 , María García-Ferrón 1 , Susana Hernando 1 , Juan Carlos Cámara-
Vicario 1 , Alicia Hurtado-Nuño 1 , Cristina Aguayo-Zamora 1 , Diana Moreno-
Muñoz 1 , Elia Pérez-Fernández 3 , Carlos Jara-Sánchez 1
1 Medical Oncology, Hospital Universitario Fundación Alcorcón, Alcorcón/Spain,
2 Oncology Department, Hospital Universitario Fundación Alcorcón, Alcorcón/
Spain, 3 Statistics Department, Hospital Universitario Fundación Alcorcón,
Alcorcón/Spain
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 inductionmaintenance
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.
Keywords: vinorelbine, NSCLC, pemetrexed, induction
POSTER SESSION 2 – P2.03A: ADVANCED NSCLC & CHEMOTHERAPY/TARGETED THERAPY/
IMMUNOTHERAPY
CLINICAL TRIALS –
TUESDAY, DECEMBER 6, 2016
P2.03A-024 THE CLINICAL EFFICACY AND SAFETY OF PACLITAXEL
LIPOSOME ON THE PATIENTS WITH NON-SMALL CELL LUNG
CANCER: A META-ANALYSIS
Xingsheng Hu 1 , Lin Lin 2 , Puyuan Xing 2 , Changgong Zhang 2 , Lin Wang 2 , Yiqun
Li 2
1 Department of Medical Oncology, Cancer Hospital,chinese Academy of Medical
Sciences & Peking Union Medical College, Beijing/China, 2 Cancer Hospital,chinese
Academy of Medical Sciences & Peking Union Medical College, Beijing/China
Background: This study was conducted to extract a specific conclusion
about the clinical efficacy of paclitaxel liposome in non-small cell lung cancer
(NSCLC). Methods: Pubmed, Embase and Chinese National Knowledge
Infrastructure (CNKI) databases were searched for potential relevant
articles. Relative risks (RRs) with 95% confidence intervals (CIs) represented
the influences of paclitaxel liposome on the objective response rate (ORR),
disease control rate (DCR) and adverse events. I2>50% and P