NORA trial (GECP 15/02): First efficacy results of the Spanish Lung Cancer Group (SLCG) phase II trial of concurrent chemo-radiotherapy (CT-RT) with cisplatin (P) plus metronomic oral vinorelbine (mOV) for unresectable locally advanced non-small cell lung cancer (LA-NSCLC).

Authors

null

Dolores Isla

Hospital Clínico Lozano Blesa, Zaragoza, Spain

Dolores Isla , Margarita Majem , Maria Guirado , Bartomeu Massuti , Ramon De Las Penas , Ana Laura Ortega Granados , Manuel Domine , Raquel Marse Fabregat , Maria Angeles Sala Gonzalez , Alfredo Paredes , Teresa Moran , Sergio Vazquez Estévez , Juan Coves , Jose Luis Gonzalez Larriba , Miguel Sánchez , David Vicente , Nuria Farre , Luis Fernandez Fornos , Francisco Valcarcel , Mariano Provencio-Pulla

Organizations

Hospital Clínico Lozano Blesa, Zaragoza, Spain, Hospital De Sant Pau, Barcelona, Spain, Hospital General de Elche, Elche, Alicante, Spain, Alicante University Hospital ISABIAL, Alicante, Spain, Oncology Service Hospital Provincial of Castellon, Castellón, Spain, Medical Oncology, Complejo Hospitalario de Jaén, Jaén, Spain, Oncology Department and Translational Oncology Division, University Hospital Fundacion Jimenez Diaz, Madrid, Spain, University Hospital Son Espases, Palma De Mallorca, Spain, Basurto University Hospital, Bilbao, Spain, Hospital Donostia, San Sebastian, Spain, Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain, Hospital Xeral-Calde de Lugo, Lugo, Spain, University Hospital Son Llàtzer, Palma De Mallorca, Spain, Hospital Clínico San Carlos, Madrid, Spain, University Hospital de la Princesa, Madrid, Spain, Hospital Universitario Virgen Macarena, Seville, Spain, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, General University Hospital de Alicante, Alicante, Spain, University Hospital Puerta del Hierro, Majadahonda, Spain, Hospital Puerta de Hierro, Madrid, Spain

Research Funding

Other

Background: CT-RT is the standard treatment for unresectable LA-NSCLC. P plus vinorelbine is widely used. Metronomic CT is a frequent administration of low doses of CT. mOV has shown good efficacy and improved safety, and could improve the RT effect. Our goal is to evaluate the efficacy and safety of P-mOV with radical RT in patients (pts) with LA-NSCLC. Methods: Pts aged 18-75 years with histologically proven untreated and unresectable LA-NSCLC, adequate bone marrow, hepatic & renal function, ECOG PS0-1, received P 80mg/m2 D1 every 3 weeks combined with mOV 50mg/day on days D1, 3 & 5/weekly, 2 cycles (cy) as induction; patients without progression received 2 more cy of P at the same dose with mOV 30mg/day on D1, 3 & 5/weekly, concurrently with RT (66Gy in 6.5weeks). Primary endpoint was progression-free survival (PFS) by RECIST v1.1; secondary endpoints were: overall response rate (ORR), disease control rate (DCR), overall survival and safety profile. To guarantee an overall type-1 α error no greater than 0.05 and a type II (β) error 0.1 for PFS, a sample size of 67 pts was planned. Results: Sixty-seven pts were recruited in 17 Spanish sites from 04/2016 to 06/2017. One of them didn’t meet all the inclusion criteria. We analyzed the first 57 pts included. Pt characteristics: Male 77.3%; median age 62 (range 33-75); PS 0/1 50/50%; smokers 45.5%; adenocarcinoma/squamous 34.8/43.9%; stage IIIA/B 43.9/56.1%. Only 29.8% of pts presented any grade 3-4 adverse event, including: neutropenia 22.8%; anemia 3.5%; febrile neutropenia 7%; esophagitis 1.8%; pneumonitis 1.8%. There were two deaths non-related to the treatment, during this period. Forty-four pts have completed the treatment. ORR: 66.7%. DCR: 79%. With a median follow-up of 11.2 months (range 1.1-21.7), the median PFS is 11.9 months (CI95%; 10.1-NR). Conclusions: mOV-P with RT is as effective as the standard administration of vinorelbine, improving its safety profile. EudraCT 2015-003312-21. Clinical trial information: EudraCT 2015-003312-21.

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers

Track

Lung Cancer

Sub Track

Local-Regional Non–Small Cell Lung Cancer

Clinical Trial Registration Number

EudraCT 2015-003312-21

Citation

J Clin Oncol 36, 2018 (suppl; abstr 8537)

DOI

10.1200/JCO.2018.36.15_suppl.8537

Abstract #

8537

Poster Bd #

143

Abstract Disclosures