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Z. Wang



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    Poster Session (ID 8)

    • Event: ACLC 2018
    • Type: Poster Session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 11/07/2018, 00:00 - 00:00, Poster Hall
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      P036 - Rechallenge Pemetrexed-Based Chemotherapy Provides an (ID 86)

      00:00 - 00:00  |  Author(s): Z. Wang

      • Abstract

      Background:
      In clinical practice, various treatments for advanced non-small-cell lung cancer (NSCLC) have been developed, aiming to alleviate the symptoms, prolong the survival and improve the life quality.Due to the absence of a standard multi-line treatment in advanced NSCLC, we hypothesized efficacy from rechallenge with pemetrexed alone or in combination with platinum or taxane for patients previously treated with pemetrexed. This article mainly observed the clinical efficacy and safety of rechallenge pemetrexed-based chemotherapy in locally advanced or metastatic NSCLC patients who had achieved first-line pemetrexed related benefitial response.


      Method:
      This retrospective study captured clinical data from 34 eligible pemetrexed rechallenge patients with advanced NSCLC who received benefitial response with first-line pemetrexed-platinum chemotherapy between January 2012 and December 2017.The progress time and safety of the disease were mainly observed.


      Results:
      With a median follow-up of 30.8 months,the DCR rate were 82.4%,with PR in 4 (11.8%) and SD in 24 (70.6%).Median rechallenge progression free survival(PFS) was 9.35 months, range from 0.9 to 44.2 months. Median overall survival (OS) was 42.2 months, range from 15.3 to 87.1 months.Patients with initial PFS (PFS1) of ?10 months had a longer rechallenge PFS compared to those with a PFS1 of <10 months (median PFS: 9.23 vs. 3.40 months;P=0.047).The significant prognostic factors for prolonging PFS after pemetrexed rechallenge are PFS1 (?10 vs <10 months,HR,0.383;95% CI,0.153-0.960;P=0.041) and line of rechallenge (2nd/3rd vs ?4th,HR,0.358;95% CI,0.145-0.880;P=0.025).It is noteworthy that maintenance treatment(HR,5.553;95% CI,1.266-24.361;P=0.023),and treatment-free survival(TFS)(?15 vs <15 months, HR,0.266; 95% CI,0.074-0.953 ; P=0.042) were indicated significant beneficial prognostic factors for overall survival(OS).Overall,pemetrexed-based rechallenge treatment was well tolerated. 0001.jpg


      Conclusion:
      Our results revealed that pemetrexed rechallenge strategy may be an option for advanced NSCLC patients who had shown beneficial response to previous pemetrexed-platinum chemotherapy.Therefore, patients with a PFS1 of ?10 months,TFS ?15 months,? 3rd line and rechallenge maintainance may be selected as benefit subgroups for pemetrexed rechallenge.