Abstract 3666
Background
Non-small cell lung cancer (NSCLC) is one of the commonest disease worldwide and the leading cause of cancer-related death. Incidence increases with age and reaches a peak in senility, when patients’ (pts) comorbidities may limit the efficacy of treatments. At this time, no homogeneous indications are available for elderly NSCLC pts and the optimization of treatment, with the lowest side effects, is still an unmet need, also after the introduction of innovative drugs. The ribonucleotide reductase catalytic subunit M1(RRM1), the DNA-excision repair protein ERCC1 and the thymidylate synthetase (TS) are cancer molecular markers able to predict response to gemcitabine, platinum compounds and pemetrexd, respectively. Originally, aim of the EPIC study (active from July 2012) was to optimize survival of elderly NSCLC pts with the use of a genomic driven chemotherapy, comparing it to standard treatment. After the proven efficacy of first-line immunotherapy, on June 2018 the protocol was amended with the introduction of a new study arm, aiming to clarify the best strategy in this setting.
Trial design
EPIC is an Italian multicenter, randomized phase III trial, comparing Avelumab (A) vs genomic driven chemotherapy (B) and genomic driven chemotherapy vs standard chemotherapy according to investigator’s choice (C) in elderly untreated NSCLC pts, randomized in a 2:2:1 fashion manner. Age over 70 years, ECOG performance-status 0-1, stage IV non-oncogene addicted NSCLC and tissue availability for gene expression analysis, are key inclusion criteria. Before study entry, pharmacogenomic evaluations of RRM1, ERCC1 and TS is performed in the entire study population, but results are disclosed only to pts randomized in arm B to not influence subsequent treatments in the other arms. Primary endpoint of the EPIC study is overall survival (OS), while secondary endpoints include progression-free survival (PFS) and treatment response rate (by investigator’s assessment). Further objectives are the evaluation of feasibility of treatment selection based on pharmacogenomic parameters, and treatment-related toxicities in every study arm. End of enrollment is expected by the end of 2022.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Department of Oncology - University of Turin, Italy.
Funding
Italian Pharmacology Agency (AIFA).
Disclosure
E. Capelletto: Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Boehringer Ingelheim. F. Grossi: Advisory / Consultancy: Eli Lilly; Advisory / Consultancy: Roche; Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Pierre Fabre; Advisory / Consultancy: BMS; Advisory / Consultancy: MSD; Advisory / Consultancy: Novartis. P. Bidoli: Advisory / Consultancy: Eli Lilly; Advisory / Consultancy: Boheringher; Advisory / Consultancy: BMS. O. Caffo: Honoraria (self): Pfizer ; Honoraria (institution): AstraZeneca. S. Novello: Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy, Speaker Bureau / Expert testimony: Eli Lilly; Advisory / Consultancy: BMS; Advisory / Consultancy: MSD; Advisory / Consultancy: Roche ; Advisory / Consultancy: Takeda; Advisory / Consultancy: Pfizer; Advisory / Consultancy: AbbVie; Advisory / Consultancy: Celgene. G. Scagliotti: Advisory / Consultancy, Speaker Bureau / Expert testimony: Eli Lilly; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Roche; Advisory / Consultancy: MSD; Advisory / Consultancy: Pfizer. All other authors have declared no conflicts of interest.
Resources from the same session
3181 - Effects of Three Products in the Prevention and Treatment of Chemotherapy and Radiation Therapy-Induced Oral Mucositis
Presenter: Francesca Zannier
Session: Poster Display session 1
Resources:
Abstract
2433 - Boiling Histotripsy-induced Mechanical Ablation Modulates Tumour Microenvironment by Promoting Immunogenic Cell Death of Cancers
Presenter: Cheol-Hee Shin
Session: Poster Display session 1
Resources:
Abstract
2663 - The bacterial receptor NOD2 mediates LGR5+ intestinal stem cells protection against irradiation via mitophagy activation
Presenter: Antonin Levy
Session: Poster Display session 1
Resources:
Abstract
3213 - Pulse mode irradiation regimen of PDT results in high progression free and overall survival in mice with model tumor
Presenter: Alexey Bogdanov
Session: Poster Display session 1
Resources:
Abstract
3722 - Proton-sensitizing effect of small molecule inhibitor of P300 histone acetyltransferase C646 in human pancreatic cancer cells.
Presenter: Sungwon Shin
Session: Poster Display session 1
Resources:
Abstract
5805 - Red-Blood-Cell-Membrane-Enveloped Magnetic Nanoclusters as a Biomimetic Theranostic Nanoplatform for Bimodal Imaging Guided Cancer Photothermal Therapy
Presenter: sheng wang
Session: Poster Display session 1
Resources:
Abstract
5251 - Urine cell-free and extracellular vesicle cargo miRNAs as biomarkers for prostate cancer diagnosis
Presenter: Ivan Zaporozhchenko
Session: Poster Display session 1
Resources:
Abstract
3657 - Parkin, APEX1 and BCL2L1 Tissue Expression in Southern Brazilian Patients with Different Breast Cancer Molecular Subtypes
Presenter: Bianca Cabral
Session: Poster Display session 1
Resources:
Abstract
2839 - Obesity and prognosis in breast cancer
Presenter: Noha Ibrahim
Session: Poster Display session 1
Resources:
Abstract
5132 - SIPA1 is a modulator of HGF induced tumor metastasis via the regulation of tight junctions in lung adenocarcinoma cells
Presenter: Chang Liu
Session: Poster Display session 1
Resources:
Abstract