1247P - Analysis of patients treated with cisplatin or carboplatin-based doublet chemotherapy in the European FRAME observational study

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
Presenter Egbert Smit
Citation Annals of Oncology (2014) 25 (suppl_4): iv426-iv470. 10.1093/annonc/mdu349
Authors E.F. Smit1, D. Moro-Sibilot2, J. De Castro Carpeno3, K. Kmak-Lesniewski4, J.G. Aerts5, R. Villatoro6, K. Kraaij7, K. Nacerddine8, Y. Dyachkova9, K. Smith10, A. Girvan10, C.M. Visseren-Grul11, P.A. Schnabel12
  • 1Dept. Of Pulmonary Diseases, Vrije University Medical Centre (VUMC), NL-1081 HV - Amsterdam/NL
  • 2Pneumologie, CHU grenoble, 38 - grenoble/FR
  • 3Unidad De Oncología Traslacional, Hospital Universitario, Madrid/ES
  • 4Onkologii, Medical University of Gda´nsk, Gdynia/PL
  • 5Pulmonary Diseases, Amphia Hospital/Erasmus MC, 4818CK - Breda/NL
  • 6Unidad Oncologia Médica, Hospital Costa del Sol, Marbella/ES
  • 7Oncology, Eli Lilly and Company, Houten/NL
  • 8Oncology, Eli Lilly and Company, Neuilly-sur-Seine/FR
  • 9Statistics, Eli Lilly GmbH, Vienna/AT
  • 10Oncology, Eli Lilly and Company, Indianapolis/US
  • 11Medical Oncology, Eli Lilly, Houten/NL
  • 12Institute Of Pathology, University of Heidelberg, Heidelberg/DE

Abstract

Aim

FRAME was a prospective observational study of patients (pts) receiving platinum (plt)-based chemotherapy as first-line treatment (FLT) for advanced or metastatic non-small cell lung cancer (NSCLC) across Europe between 2009 and 2012.

Methods

The study primary objective of overall survival was previously reported. Here, we describe the association between baseline characteristics and the physician's choice of a cisplatin (cis) or carboplatin (cb) backbone for FLT observed in FRAME. The distribution of baseline characteristics was compared by t-test or χ2-test and summarized by propensity of receiving cb estimated by logistic regression. Cohorts were matched by propensity score; survival for matched pts was compared using Kaplan-Meier approach.

Results

In total, 1520 pts received either cis (n = 825) or cb (n = 695) in combination with either: pemetrexed, gemcitabine, taxanes or vinorelbine, and were analyzed here. Pts prescribed cb were on average older, had worse ECOG PS and were more likely to have squamous histology than pts who received cis (Table 1); they also had more pre-existing conditions (cardiovascular p < .001; lung p = .005; kidney p < .001), greater weight loss 6 months before FLT (p = .002) and were more likely to receive FLT at an office (vs. hospital)-based practice than pts who received cis (p < .001). Characteristics not significantly associated with cis or cb choice included gender, race, stage at study entry and physician specialty. Due to significant differences in many baseline characteristics, <50% of pts could be matched by propensity score for survival analysis. Of matched pts (349 in each cohort), median survival in months (95% CI) was 10.8 (8.8-14.3) for cis and 9.5 (8.2-11.3) for cb; p = 0.086.

Cis (n = 825) Cb (n = 695) p-value
≥70 yrs (%) 15 47 <.001
ECOG PS (%) Gr 0-1 Gr 2-3 87 12 77 22 <.001
FLT (+plt) (%) pemetrexed (n = 567) gemcitabine (n = 360) taxanes (n = 293) vinorelbine (n = 300) 47 23 9 21 26 24 31 19 <.001
Histology (%) Squamous (sq) Non-sq 23 75 26 70 .031

Conclusions

FRAME observed that age, ECOG PS, pre-existing conditions and pathological diagnosis have strong associations with the choice of cis or cb in FLT for advanced or metastatic NSCLC across Europe.

Disclosure

D. Moro-Sibilot: Consulting fees from Eli Lilly and Company, Roche, Astra Zeneca, Boehringer Ingelheim France, Amgen; J. De Castro Carpeño: Speakers Bureau for Roche; Advisory board for Eli Lilly and Company, Roche and Pfizer; K. Kmak-Lesniewski: Invited speaker for Eli Lilly, Roche, Astra Zeneca, GSK, Amgen; J.G. Aerts: Research grant from and Consultant for Eli Lilly and Company. Advisory board for Eli Lilly and Company, Roche Genentech and BMS; R. Villatoro: Speaker fee from Jansen, Pfizer; K. Kraaij: Employee and stockholder of Eli Lilly and Company; K. Nacerddine: Employee and stockholder of Eli Lilly and Company; Y. Dyachkova: Employee and stockholder of Eli Lilly and Company; K. Smith: Employee of Eli Lilly and Company; A. Girvan: Employee and stockholder of Eli Lilly and Company; C.M. Visseren-Grul: Employee and stockholder of Eli Lilly and Company; P.A. Schnabel: Speakers Bureau for AstraZeneca, InterMune, Eli Lilly and Company, Novartis, Pfizer, Roche. Advisory board for AstraZeneca, Eli Lilly and Company, Novartis, Roche. Prior research funding from Eli Lilly and Company. All other authors have declared no conflicts of interest.