Abstract 1330
Background
There is a lack of well-established biomarkers to predict the efficacy of pemetrexed-based therapy. In this prospective phase II study, we investigated the correlation of folate receptor (FR)-positive circulating tumor cell (CTC) level with pemetrexed efficacy in patients with advanced non-squamous non-small cell lung cancer (nsNSCLC).
Methods
A total of 98 nsNSCLC patients were enrolled. Peripheral blood was collected from each patient prior to initiation of treatment. FR-positive CTCs were enriched by immunomagnetic leukocyte depletion and quantified using LT-PCR method.
Results
Patients with relatively low CTC level (11-16 FU/3 mL, n = 32) showed a significantly shorter progression-free survival (PFS) and overall survival (OS) compared to the ‘high CTC level group’ (≥16 FU/3 mL, n = 28; median PFS: 133 versus 320 days, hazard ratio[HR]=4.78, P = 0.0008; median OS: 632 days versus ‘not reached’, HR = 10.89, P = 0.0013). The ‘high CTC level group’ also achieved superior objective response rate (ORR) and disease control rate (DCR) over the ‘low CTC level group’ (ORR: 40.9% versus 9.5%, P = 0.0339; DCR: 100% versus 81.0%, P = 0.0485). The efficacy of pemetrexed in the ‘negative-CTC group’ (<11 FU/3 mL, n = 38) falls between the ‘high CTC level group’ and the ‘low CTC level group’ (median PFS: 290 days; median OS: 1122 days; ORR: 21.2%; DCR: 93.9%). When patients received only 1 cycle of treatment (n = 10) were excluded, the differences in both ORR, DCR, and OS between the CTC subgroups were more significant.
Conclusions
Our results implied that FR-positive CTC is an efficacious biomarker to predict the outcome of first-line pemetrexed-based therapy in nsNSCLC patients.
Clinical trial identification
ChiCTR-ONC-13003475.
Editorial acknowledgement
Legal entity responsible for the study
Shanghai Pulmonary Hospital.
Funding
This study was partially supported by Shanghai Committee of Science and technology (No. 14411970800). The funder had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4852 - Impact of routine screening and preemptive treatment on hepatitis B virus reactivation (HBVr) in patients receiving chemotherapy
Presenter: Celine Marty
Session: Poster Display session 1
Resources:
Abstract
5225 - The uptake, patient satisfaction and efficacy of scalp cooling among patients receiving chemotherapy in an Irish oncology day ward.
Presenter: William Maher
Session: Poster Display session 1
Resources:
Abstract
1901 - Placebo adverse events (AEs) in targeted and immune cancer therapy in the adjuvant and advanced setting: A systematic review and meta-analysis
Presenter: Diego Enrico
Session: Poster Display session 1
Resources:
Abstract
3258 - Reduced antibody levels and high seronegativity rates against vaccine preventable diseases pose a risk factor for infections in patients with solid and hematologic cancers
Presenter: Angela Guzek
Session: Poster Display session 1
Resources:
Abstract
3211 - Prognostic Factors Influencing Outcome After Therapy With Brentuximab Vedotin in Patients with Relapsed or Refractory Hodgkin's Lymphoma
Presenter: Veselina Goranova - Marinova
Session: Poster Display session 1
Resources:
Abstract
4949 - Phase I Study of CC-90010 in Patients With Advanced Solid Tumors and Relapsed/Refractory Non-Hodgkin Lymphoma (R/R NHL)
Presenter: Victor Moreno
Session: Poster Display session 1
Resources:
Abstract
2271 - Pretreatment coagulation factors related to prognosis in patients with natural killer/T cell lymphoma
Presenter: Yue Chai
Session: Poster Display session 1
Resources:
Abstract
4335 - Diffuse large B cell lymphoma in the elderly. A retrospective analysis of standard versus alternative treatments
Presenter: Irene Sillero
Session: Poster Display session 1
Resources:
Abstract
5117 - MIPI as a superior prognostic tool in Mantle Cell Lymphoma compared to monocyte-lymphocyte, neutrophil-lymphocyte and platelet-lymphocyte ratios
Presenter: Filipa Macedo
Session: Poster Display session 1
Resources:
Abstract
5135 - Dose adjustment of chemotherapy in aggressive lymphoma using automated and standardized analysis and evaluation of DNA double strand breaks
Presenter: Julia Schröder
Session: Poster Display session 1
Resources:
Abstract