Abstract 524P
Background
Recurrence is a rule after 1st line therapy in small cell lung cancer (SCLC). Patients who would not tolerate platinum or who recur within 6 months of 1st line therapy; choice of 2nd line is not well defined in them.
Methods
SCLC patients, who progressed within 6 months after 1st line, or at anytime but who are not candidates for platinum, were non-randomly assigned to receive Paclitaxel 80mg/m2 weekly or Irinotecan 100mg/m2 weekly, till progression or for 12 cycles, or Temozolomide 75mg/m2 21days, every 4 weekly for 6 cycles in patients with brain metastasis. Response, toxicities, survival durations were noted.
Results
In Irinotecan arm 1(12.5%) had PR, 2(25%) had SD and 3(37.5%) had PD (Response rate[RR]=37.5%). In the Taxane arm, 2(9.5%) had CR, 8(38.0%) had PR, 5(23.8%) had SD, and 6(28.5%) had PD (RR = 71.4%). 2(33.3%) had PR, 1(16.6%) had SD (RR = 50%) in the Temozolomade arm. Mean and median PFS after 2nd line after a min follow up of 18 months was 2.27 and 1.5 months for the whole cohort. Same for Taxane, Irinotecan and Temozolomide were (3.04 and 3 months), (0.81 and 0 months) and (1.5 and 0 months) respectively (p = 0.035). HR for progression for Taxane and Irinotecan were (0.565 p = 0.24, 95% CI [0.218-1.464]) and (1.358 p = 0.575, 95% CI [0.466-3.957]) respectively. Avg grade ¾ haematologic toxicities, febrile neutropenia, GI and hepatotoxicities were lowest for Taxane (0.81/patient p = 0.001, 0.48/patient p = 0.047, 1.14/patient p = 0.137 and 0.19/patient p = 0.08 respectively). Hypersensitivity (all grades) were more common for Irinotecan than taxane (0.62 vs 0.33/patient, p = 0.196). 3 patients died of causes attributed to therapy (2 out of 8 [25%] of Irinotecan arm, 1 out of 21 [4.7%] of Taxane arm). Median OS for the whole cohort was 11.5 months; highest for Taxane 12.5 months> 11 months for Temozolomide>9.5 months for Irinotecan, p = 0.185. HR for death for Taxane and Irinotecan were (0.643 p = 0.376, 95% CI [0.242-1.710]) and (1.383 p = 0.550, 95% CI [0.477-4.009]) respectively.
Conclusions
Weekly Paclitaxel in 2nd line may have favourable toxicity profile and response rate comparable to Irinotecan or Temozolomide; may translate into better quality of life and OS.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
481P - Updated survival outcomes of the phase II study of low starting dose of afatinib as first-line treatment in patients with EGFR mutation-positive non-small cell lung cancer (KTORG1402)
Presenter: Toshihide Yokoyama
Session: Poster display session
Resources:
Abstract
490P - Outcomes of sequential epidermal growth factor receptor tyrosine (EGFR) tyrosine kinase inhibitor (TKI) therapy in patients with advanced non-small cell lung carcinoma (NSCLC)- a real-world institutional experience
Presenter: Yvonne Ang
Session: Poster display session
Resources:
Abstract
498P - An observational retrospective study to evaluate the incidence of acquired EGFR T790M resistance in NSCLC patients with EGFR mutation following progression after at least one prior EGFR TKI treatment in Taiwan: ARISE study
Presenter: Shang-gin Wu
Session: Poster display session
Resources:
Abstract
501P - Clinical characteristics and efficacy in non-small cell lung cancer patients with EGFR exon 20 insertion and EGFR amplification
Presenter: Xin Gao
Session: Poster display session
Resources:
Abstract
502P - Epidermal growth factor receptor tyrosine kinase inhibitor treatment response in advanced non-small cell lung cancer with uncommon mutations: A multicenter observational study
Presenter: Masaki Kanazu
Session: Poster display session
Resources:
Abstract
482P - Interim analysis from a phase IIIb, open-label study of afatinib in EGFR TKI-naïve patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC
Presenter: Filippo De Marinis
Session: Poster display session
Resources:
Abstract
483P - A phase IIIb, open-label study of afatinib in EGFR TKI-naïve patients with EGFR mutation-positive NSCLC: A biomarker analysis
Presenter: Rafael Rosell
Session: Poster display session
Resources:
Abstract
484P - Activity of afatinib in patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC and baseline brain metastases: Pooled analysis of three large phase IIIb trials
Presenter: Maya Gottfried
Session: Poster display session
Resources:
Abstract
491P - Clinical outcomes of leptomeningeal metastases in EGFR-mutant lung adenocarcinoma
Presenter: Chia-I Shen
Session: Poster display session
Resources:
Abstract
510P - Paclitaxel as continuation maintenance therapy in patients with advanced non-small cell lung cancer
Presenter: Suzy Gohar
Session: Poster display session
Resources:
Abstract