Lung Cancer Unit, Ospedale Policlinico San Martino, Genoa, Italy
Francesco Grossi , Piotr Jaskiewicz , Eric Pichon , Grzegorz Czyzewicz , Dariusz Kowalski , Libero Ciuffreda , Ramon Garcia-Gomez , Salvatore Caruso , Joaquim Bosch-Barrera , Christine Ta Thanh Minh , Sebastien Henriet , Stephanie Gautier , Helene Hervieu , Gilberto Castro Jr.
Background: The doublets OV+P and GEM+P are among standard treatment options in NSCLC. The study aims to assess efficacy, safety of OV+P (Arm A) and GEM+P (Arm B), followed by maintenance with OV or GEM respectively. Methods: Pts were randomised to receive (every 3-week cycles): OV at 80 mg/m² D1 and D8 (60 mg/m² Cycle 1) + P 80 mg/m² D1 or GEM 1250 mg/m² (D1 and D8) + P 75 mg/m² D1. After 4 cycles of combination, pts without progressive disease received single agent OV or GEM respectively as maintenance until progression or unacceptable toxicity. Primary endpoint: Disease Control Rate (DCR) on study treatment period (combination,maintenance). Results: 113 pts were included in intent-to-treat population (ITT): Baseline: 57 pts (Arm A)/ 56 pts (Arm B), median age of 61 and 64.5 years, stage IV 96.5% and 91.1% respectively. In Arm A/ B, 57 pts and 56 were treated in combination period; in maintenance, 29 and 28 pts were treated with OV or Gem. Results (ITT) for study treatment period in Arm A/ B: DCR 73.7% [95%, CI (62.4; 100.0)] and 75% [95%, CI (63.7; 100.0)]. Median duration of treatment 12.1 and 13.2 weeks; objective response 24.6% [14.1; 37.8] and 30.4% [18.8; 44.1]; median [95% CI] duration of disease control in months (mo) 4.8 [4.1-5.7] and 5.2 [4.3-6.6]; median PFS: 4.2 (2.8-4.9) and 4.3 (3.1-5.5) mo; median survival: 10.2 (6.9-12.9) and 8.4 (5.3-11.9) mo. Total of any grades (Gr) of related adverse events (r-AEs) arm A/ B respectively: 87.7% and 92.9%. Any grade of related infections : 1.8% vs 8.9%.Gr 3-4 of selected r-AEs: nausea/vomiting 1.8%/3.5% vs 8.9%/ 5.4%, peripheral neuropathy 0% vs1.8%, renal failure 1.8% vs 3.6%, septic shock 0 vs 1.8%. Grade 1-2 related alopecia (8.8% vs 21.4%). One toxic death in each arm. Biological toxicities of gr 3-4 neutropenia 43.9%/37.5%, anaemia 17.5%/10.7%, thrombocytopenia 1.8%/10.7%. Full results to be presented at the meeting. Conclusions: This study confirms efficacy, safety of OV+P in sq NSCLC with a trend for a better median survival for OV+P. Clinical trial information: 2012-003531-40.
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