132P - Weekly carboplatin and paclitaxel in advanced non-small cell lung cancer: Good response rate but poor overall survival in a "real world" population

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
Presenter Michael Mark
Citation Annals of Oncology (2015) 26 (suppl_1): 29-44. 10.1093/annonc/mdv050
Authors M. Mark1, V. Volk2, U. Mey1, P. Brossart2, R. Von Moos1, R. Cathomas1
  • 1Dept. Oncology/hematology, Kantonsspital Graubünden, 7000 - Chur/CH
  • 2Hämatologie/onkologie, Universität, Bonn/DE

Abstract

Aim/Background

A large proportion of patients with non-small cell lung cancer (NSCLC) are diagnosed at an advanced stage and the 5-year survival rate is around 4%. Despite the increasing availability of targeted therapies for molecularly defined NSCLC subsets, platinum-based chemotherapy remains the most commonly used treatment modality. However, many patients with NSCLC are frequently of older age, have symptomatic disease with an impaired performance status (PS) and often cannot tolerate standard 3-weekly platinum-doublets. Therefore, weekly combination chemotherapy regimens might offer advantages concerning tolerability in this patient population.

Methods

This is a retrospective single center analysis of all consecutive patients with stage IIIB/IV NSCLC treated with weekly carboplatin (C) AUC 3 in combination with weekly paclitaxel (P) 75mg/m2 (d1, 8, 15; q4w) as palliative first or second line chemotherapy between August 2004 and May 2014. The primary objective was to assess efficacy and toxicity.

Results

A total of 101 patients were treated with CP, 90 patients (89 %) as 1st-line, 11 (11%) as 2nd- line treatment. 95% had stage IV disease. Median age was 66 years (range 39-88). 25% had brain metastases and 20% had an ECOG PS ≥2.A median of 2 cycles (range 1-6) and 6 weekly doses (range 1-18) were given per patient, respectively. The response rate for all patients was 32% and an additional 26% had stable disease. Median PFS was 3.4 months (0.2-16.8). The median OS was 6.3 months (0.3-75). 26% of all patients had a survival of less than 12 weeks. Most common adverse events ≥ grade 3 were fatigue (22%), neutropenia (17%) and neuropathy (5%). PS was the only variable with a statistically significant impact on response rate and OS.

Conclusions

The combination of weekly carboplatin and weekly paclitaxel results in good response rates and acceptable toxicity in an unselected population of patients with stage IV NSCLC and a high proportion of brain metastases and impaired PS. Nonetheless, OS remains poor in this “real world” cohort with a substantial number of patients surviving less than three months. This implies that this regimen should only be used in patients with acceptable PS.

Disclosure

All authors have declared no conflicts of interest.