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Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Presentations: 1
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
181P - Real-world comparative effectiveness of treatment sequences in metastatic non-small cell lung cancer with squamous histology (ID 458)
12:30 - 13:00 | Author(s): M. Parisi
Commonly used first-line (1L) chemotherapies for metastatic non-small cell lung cancer (mNSCLC) include gemcitabine + platinum-based agent (Gem/Platinum), nab-paclitaxel + carboplatin (nab-P/C), and sb-paclitaxel + carboplatin (sb-P/C). Head-to-head trials and prospective data comparing these treatments and subsequent lines of treatment including immunotherapy (IO) are limited.
This retrospective cohort study compared the efficacy of 1L Gem/Platinum, nab-P/C, and sb-P/C among mNSCLC patients with squamous histology, and among patients who subsequently received 2L IO therapy. Medical records of adult patients who initiated these 1L treatments between 06/2014–10/2015 were reviewed by 132 participating physicians. Overall survival (OS) and progression free survival (PFS) was evaluated using Kaplan-Meier curves, and compared between cohorts using Cox proportional hazards model adjusting for baseline characteristics.
Medical records of 458 mNSCLC patients with squamous histology receiving Gem/Platinum (n = 139), nab-P/C (n = 159), or sb-P/C (n = 160) as 1L therapy were reviewed. Demographics, ECOG and number of comorbidities were balanced among 1L cohorts. 1L nab-P/C was associated with a longer median OS (23.9 months) than Gem/Platinum (16.9 months; adjusted HR vs nab-P/C = 1.55, p < 0.05) and sb-P/C (18.3 months; adjusted HR vs nab-P/C = 1.42, p = 0.10). There were no statistically significant differences in PFS (median PFS of 8.8, 8.0 and 7.6 months for Gem/Platinum, nab-P/C, and Sb-P/C, respectively). 37%, 46% and 40% of patients with 1L Gem/Platinum, nab-P/C and Sb-P/C received a 2L IO. For the subgroup of patients in the three chemotherapy groups who received both 1L chemotherapy and 2L IO therapy, there were no statistically significant differences in OS (median OS of 27.3, 25.0 and 23.0 months, respectively).
In a nationwide sample of mNSCLC patients with squamous histology, 1L nab-P/C was associated with a longer median OS compared with 1L Gem/Platinum, and a statistically non-significant difference compared with 1L sb-P/C. Median OS was similar across 1L agents among the subgroup of patients who sequenced to a 2L IO.
Clinical trial identification:
Legal entity responsible for the study:
H. Yang, J.E. Signorovitch, O. Patterson-Lomba, C.Q. Xiang,: Employee of Analysis Group, Inc., which has received consultancy fees from Celgene. B.P. Levy: Consultancy fees from Celgene. M. Parisi: Celgene employee.