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A. Joshi



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    P2.01 - Advanced NSCLC (ID 618)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P2.01-051 - Randomized Study of Pemetrexed Versus Erlotinib as Maintenance Therapy in Metastatic /Locally Advanced EGFR Mutation Negative NSCLC (ID 10362)

      09:00 - 16:00  |  Author(s): A. Joshi

      • Abstract

      Background:
      Maintenance treatment of locally advanced or metastatic non small cell lung cancer ( NSCLC ) other than predominantly Squamous cell histology in patients whose disease has not progressed following 4 to 6 cycles of platinum based doublet therapy has been standard of care . Pemetrexed and Erlotinib both have been used as either continuous maintenance or switch maintenance therapy.

      Method:
      All patients of NSCLC other than the Squamous cell carcinoma , who have completed either 4 or 6 cycles of platinum and pemetrexed and have either CR /PR/SD on response assessment scan post induction treatment and willing to participate in study ,were randomized to receive either pemetrexed or erlotinib . Quality of life (QoL) questioners were collected every 8 weeks till disease progression or unacceptable toxicities. Patients were followed up till death. PFS and OS were calculated for each arm and indirectly compared.

      Result:
      Two hundred patients were randomized to receive either pemetrexed or erlotinib) from November 2014 to March 2017. Median age of cohort was 55 (28-79).One hundred and thirty two patients were male and 68 were female. PS was 0-1 in 195 patients. Sixty three percent were smokers (126/200). Majority of patients (62.5 %) has stable disease post completion of induction chemotherapy (125 /200).Median number of cycle of maintenance pemetrexed was 4 (4-6). Median PFS in pemetrexed arm was 4.46 month ( 95 % confidence interval (CI); 3.98 to 4.95 ) while in erlotinib arm median PFS was 4.5 month ( 95 % CI ; 3.98 to 4.95),( hazard ratio , 0.98 ; 95% CI , 0.714 to 1.369 , p value 0.945).Median OS from starting induction chemotherapy in pemetrexed arm was 16.56 months ( 95 % CI ; 14.83 to 18.29 ) while in erlotinib arm median OS was 18.33 months ( 95% CI ; 13.74 to 22.92),(hazard ratio , 1.23 ; ( 95 % CI ; 0.829 to 1.831 , p value 0.0302)

      Conclusion:
      Maintenance treatment with pemetrexed and erlotinib has similar PFS and OS in indirect comparison. QoL analysis in both arms is ongoing.