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J.W. Morgan



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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      166P - Evidence-based conclusions and inclinations of pemetrexed, taxane and bevacizumab in advanced lung cancer (ID 331)

      12:30 - 13:00  |  Author(s): J.W. Morgan

      • Abstract
      • Slides

      Background:
      Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death. In advanced lung cancer patients, lacking targetable mutations, platinum-based chemotherapy is a mainstay treatment. Pemetrexed and taxane are used in combination with platinum, however, there are no large randomized trials comparing first-line of these agents. Furthermore, addition of bevacizumab is sometimes used in the treatment of these patients. The objectives of this study were to compare survival in patients treated with pemetrexed vs taxane in addition to platinum, with and without bevacizumab.

      Methods:
      We extracted data for metastatic lung adenocarcinomas diagnosed 2005–2015 from the California Cancer Registry (CCR) assessing lung cancer-specific Cox proportional mortality hazards ratios (HR) for patients that had received 1. platinum + taxane vs platinum + pemetrexed and 2. bevacizumab (Y/N).

      Results:
      Of 6,034 patients enrolled in the study, 3,593 (58.5%) received platinum and taxane, 2,788 (41.5%) received platinum and pemetrexed, 1,712 (28.4%), received bevacizumab. Median survival among patients treated with pemetrexed was significantly longer than those that received taxane (12.4 months vs 10.1 months; p < 0.001). Likewise, median survival time among patients treated with bevacizumab (Y/N) was 14.8 months vs 9.8 months; p < 0.001. Significantly improved survival was evident for younger patients <65 years (HR = 0.94; 95%CI = 0.88–0.99), females (HR = 0.78; 95%CI = 0.74–0.83), Asians (HR = 0.74; 95%CI = 0.68–0.80) and Hispanics (HR = 0.86; 0.78–0.95), the highest SES quintiles (HR = 0.87; 95%CI = 0.78–0.96), and for patients treated with platinum and pemetrexed (HR = 0.82; 95%CI = 0.77–0.87) and bevacizumab (HR = 0.78; 95%CI = 0.73–0.83). Our finding revealed increases in use of pemetrexed with reductions in taxanes, while bevacizumab use peaked in 2008, followed by decline.

      Conclusions:
      Our study showed survival was significantly improved in patients who received pemetrexed in addition to platinum as compared to taxanes. Although bevacizumab has lost favour, our findings revealed additional survival benefit when combined with either chemotherapy regimen.

      Clinical trial identification:


      Legal entity responsible for the study:
      N/A

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.

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