1206P - Pemetrexed (PEM) combination therapy with carboplatin (CB) followed by PEM maintenance in Japanese patients (pts) with nonsquamous non-small cell lu...

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anti-Cancer Agents & Biologic Therapy
Geriatric Oncology
Non-Small-Cell Lung Cancer, Metastatic
Presenter Naoyuki Nogami
Authors N. Nogami1, R. Sekiguchi2, S. Enatsu2, K. Nakagawa3, T. Tamura4
  • 1Dept Of Thoracic Oncology, NHO Shikoku Cancer Center, Matsuyama/JP
  • 2Development Center Of Excellence, Eli Lilly Japan K.K., Kobe/JP
  • 3Medical Oncology, Kinki University School of Medicine, JP-589-8511 - Osaka/JP
  • 4Division Of Internal Medicine And Thoracic Oncology, National Cancer Center Hospital, Tokyo/JP

Abstract

Objectives

This subgroup analysis evaluated the efficacy and safety of Pem combination therapy with Cb followed by Pem maintenance in Japanese elderly NSCLC pts.

Patients and methods

The study was a multicenter, prospective post-marketing study which assessed the safety and efficacy of Cb AUC 6 and Pem 500 mg/m2 on Day 1 of each 21-day cycle for 4 cycles as induction therapy followed by Pem maintenance therapy. For this subgroup analysis 109 advanced nonsquamous NSCLC pts with good PS (ECOG 0-1) were grouped by age (elderly: ≥70 years, younger: <70 years).

Results

Median age (range) of the 25 elderly and 84 younger pts were 73 (70-78) and 61 (38-69) years, respectively. Other pt characteristics were PS 0/1 (elderly: 40%/60%; younger: 32%/68%) and gender M/F (elderly: 40%/60%; younger: 36%/64%). Compared with younger pts, a smaller percentage of elderly pts completed the 4-cycle induction phase (56% vs 73%) and maintenance therapy (48% vs 57%). Main reasons for elderly patient discontinuation during the induction phase were progressive disease (28%) and adverse events (16%). However the median [range] maintenance cycle in elderly pts was comparable to younger pts (5 [1-16] vs 4 [1-26] cycles). Grade 3/4 hematologic toxicities were more frequent in elderly pts: grade 3/4 neutropenia (68%), thrombocytopenia (52%), anemia (48%). Dose reduction was more common in elderly pts (44% vs 23%), mainly due to hematologic toxicity. Respective overall response rates in elderly and younger pts were 24% vs 38%. Median PFS and OS from the start of the induction phase were 5.2 and 16.8 months for elderly pts compared with 5.7 and 20.2 months for younger pts, respectively.

Conclusions

For elderly NSCLC pts with good PS, the toxicity of Pem combination therapy with Cb followed by Pem maintenance was manageable by dose adjustment for hematologic toxicities. There was no significant difference in PFS and OS. Updated data will be presented at the meeting.

Disclosure

R. Sekiguchi: Employee/Eli Lilly Japan K.K.

S. Enatsu: Employee/Eli Lilly Japan KK.

All other authors have declared no conflicts of interest.