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ANSELMA: ANtiangiogneic SEcond line Lung cancer Meta-Analysis in non-small cell lung cancer (NSCLC)

Date

08 Oct 2016

Session

Poster Display

Presenters

JORDI Remon Masip

Citation

Annals of Oncology (2016) 27 (6): 416-454. 10.1093/annonc/mdw383

Authors

J. Remon Masip1, C. Thuong2, J. Pignon3, B. Lacas3, J. Soria1, B. Besse1

Author affiliations

  • 1 Medicine - Oncologie Thoracique, Institut Gustave Roussy, 94805 Villejuif - Villejuif/FR
  • 2 Bioestatisitics, Institut Gustave Roussy, 94805 Villejuif - Villejuif/FR
  • 3 Service De Biostatistique Et D’epidemiologie, Gustave Roussy Cancer Campus, FR-94805 - Villejuif/FR
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Resources

Abstract 2478

Background

Only 20% of NSCLC patients have a response to immune checkpoint inhibitors as second-line treatment. Several randomized phase II and III trials have tested the efficacy of the combination of antiangiogenic drugs (AD) plus chemotherapy (CT) or erlotinib (E) with inconsistent benefit. We performed a meta-analysis to validate the efficacy of these agents as strategy second-line option in advanced NSCLC patients.

Methods

Randomized trials of AD plus standard second-line treatment, CT (docetaxel [Do], pemetrexed) or E compared to same standard treatment ending accrual before 2015 were included based on search of publication databases, abstract proceedings and trial registers. Data were extracted from publications. Random-effect models, in case of significant heterogeneity (Het), fixed-effect model otherwise, were used to compute pooled hazard ratios (HRs) for overall survival (OS, primary end-point) and PFS and pooled odds ratios (ORs) for response rate (RR) and adverse events. Het was studied using Q-test I2.

Results

seventeen trials with 8,703 patients were included with 3 types of combinations: 5 trials monoclonal antibodies AD + CT (Do for 5), 7 on tyrosine kinase inhibitor (TKI) AD + CT (Do for 3) and 5 AD (TKI for 4) + E. Trial size ranged from 100 to 1391 patients. ADs evaluated were: cabozantinib (1 trial), aflibercept (1), nintedanib (2), ramucirumab (2), sorafenib (2), bevacizumab (3), vandetanib (3), sunitinib (3). Control arm was docetaxel (8 trials), pemetrexed (4), E (5). Compared with standard second-line treatment alone, AD significantly prolonged OS (HR 0.94 [95% confidence interval 0.89-0.99, random-effect model; P = 0.03; P-Het = 0.004), PFS (0.79; [0.73- 0.85], random effect model; P 

Conclusions

Antiangiogenic drugs significantly prolong OS and PFS when added to standard second-line treatment in advanced NSCLC patients. Toxicity results will be presented during the congress

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

Gustave Roussy

Disclosure

All authors have declared no conflicts of interest.

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