Author of

• 25955

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  P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall

  • 27354

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    P3.01-05 - Mature Progression-Free Survival in Stage IV Non-Small Cell Lung Cancer Patients Treated With Pemetrexed Maintenance Therapy (ID 12667)

    12:00 - 13:30  |  Author(s): Parva Kiran Bhatt
    • Abstract
    • Slides

    Background
    

    Pemetrexed maintenance therapy is associated with superior survival in stage IV Non-Squamous, Non-small Cell Lung Cancer patients. We have observed long term disease control in real world patients treated with Pemetrexed(Pem)/Platinum(Plat) +/- Bevacizumab(Bev) followed by Pem +/- Bev maintenance therapy. To our knowledge, there is no mature data regarding the tail of the Progression Free Survival (PFS) curve in these patients. The objectives of this retrospective analysis are to determine the frequency of long term disease control on Pem+/- Bev maintenance and to identify parameters associated with absence of disease progression.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Our study looked at patients with Stage IV nsqNSCLC who received first line Pem/Plat followed by Pem maintenance between May 2010 and December 2017. We identified 241 patients from our database and analyzed their demographics, lab values, dates of therapy, and dates of progression. PFS was estimated by the Kaplan-Meier method and associations with patient characteristics were assessed by log-rank tests and Cox proportional hazards analysis.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Median age was 66 years, 60% female, and 72% Caucasian. Baseline ECOG performance status (PS) was 0(22%), 1(50%) and ≥ 2(22%). Disease progression was observed in 233 of 241 pts. with median PFS of 6.2 months. Absence of disease progression was observed in 34 pts. (14.2%) at 2 years, 19 pts. (7.9%) at 3 years, and 3 pts. (1.2%) at 5 years. Improved PFS was strongly associated with lower baseline neutrophil: lymphocyte ratio (NLR) when using NLR≤3.5 vs >3.5 (median PFS 9.7 mo vs 5.2 mo, p =0.004) as well as in a continuous scale (HR=1.04, p < 0.001). ECOG PS of 0/1 was also associated with superior PFS (p<.001).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    The similarity in median PFS in our patients (6.2 mo) and clinical trial data suggests that our group of real world patients did not have uniquely favorable baseline characteristics. Although long term absence of progression may have been solely due to favorable natural history of disease, we believe that it was also due to Pem maintenance. As a result, continued development of Pem plus immunotherapy regimens in nsqNSCLC may result in a higher rate of long term disease control.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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