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Wang Chun Kwok



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    MA01 - Novel Systemic Treatment in NSCLC (ID 102)

    • Event: WCLC 2020
    • Type: Mini Oral
    • Track: Antibody Drug Conjugates, Novel Therapeutics and Cytotoxics
    • Presentations: 1
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      MA01.05 - Clinical Efficacy and Safety of Pemetrexed With or Without Either Bevacizumab or Pembrolizumab in Patients With Metastatic NSCLC (ID 3178)

      11:45 - 12:45  |  Presenting Author(s): Wang Chun Kwok

      • Abstract
      • Presentation
      • Slides

      Introduction

      Pemetrexed was approved by United States Food and Drug Administration (US FDA) in combination with platinum for the treatment of advanced non-squamous non-small cell lung carcinoma (NSCLC) and malignant mesothelioma. Bevacizumab and pembrolizumab can be added to chemotherapy for patients with non-squamous NSCLC with benefits but there has not been any dedicated head-to-head comparison between pemetrexed-platinum-bevacizumab and pemetrexed-platinum-pembrolizumab on their efficacy and safety.

      Methods

      This was a retrospective single-center cohort study conducted in Queen Mary Hospital in Hong Kong. The study included 451 patients with advanced stage non-squamous NSCLC that received first line pemetrexed and platinum with or without bevacizumab or pembrolizumab. Patients who received pemetrexed-platinum were compared with those who received pemetrexed-platinum-bevacizumab and pemetrexed-platinum-pembrolizumab. The primary endpoint was the progression-free survival (PFS).

      Results

      The median PFS for patients that received pemetrexed-platinum-pembrolizumab (PAC) was significantly longer than those who received pemetrexed-platinum-bevacizumab (BAC) and pemetrexed-platinum (AC) (9 vs 6.8 vs 4.8 months, p < 0.05 among all 3 groups), with OR of 0.430 (95% CI 0.273 – 0.675, p < 0.001) and 0.578 (95% CI 0.343 – 0.976, p = 0.040) when compared to AC and BAC respectively. Patients who received PAC also had a higher response rate and higher likelihood to receive continuation maintenance therapy than those on AC. There is no statistically significant difference in the grade 3 to 4 toxicity among the three treatment groups.

      Conclusion

      Pemetrexed-platinum-pembrolizumab provides superior PFS to pemetrexed-platinum-bevacizumab and pemetrexed-platinum without a significant increase in toxicity.

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