Best of ASCO - 2014 Annual Meeting

 

Welcome

Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.

Overall survival in PEMVITASTART randomized trial comparing immediate vs. conventional strategies of vitamin supplementation in NSCLC patients on 1st line pemetrexed-platinum chemotherapy.

Sub-category:
Metastatic Non-Small Cell Lung Cancer

Category:
Lung Cancer—Non-Small Cell Metastatic

Meeting:
2019 ASCO Annual Meeting

Abstract No:
e20538

Citation:
J Clin Oncol 37, 2019 (suppl; abstr e20538)

Author(s): Navneet Singh, Valliappan Muthu, Kuruswamy Thurai Prasad, Milind Baldi; Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

Abstract Disclosures

Abstract:

Background: PEMVITASTART (NCT02679443) was an open label phase II randomized trial [Singh N, et al. Cancer (DOI: 10.1002/cncr.32028)] involving locally advanced/metastatic non-squamous NSCLC patients treated with 1st line pemetrexed-platinum chemotherapy (CTx). The trial assessed the hematological toxicity profile in Delayed Arm (DA; conventional strategy) in whom CTx was initiated after 5-7 days of vitamin B12/folate supplementation (B12-FAS) vs. Immediate Arm (IA) in whom patients received B12-FAS simultaneously (≤24 hours) with CTx initiation. All outcomes were reported in modified ITT population (patients who received ≥1 cycle). A non-significant trend towards better radiological responses was observed in IA (PR 33% vs. 18%; p = 0.06). Herein, we report exploratory post-hoc analysis of overall survival (OS) for the mITT population (n = 150; 77 IA, 73 DA) of PEMVITASTART. Methods: OS was calculated from date of enrolment to date of death/last follow up. Survival cutoff date was 28 months after last patient enrolment. Median OS was calculated by Kaplan-Meier method and group differences analyzed by log-rank test. Factors affecting OS were assessed by Cox proportional hazards (CPH) analysis and hazard ratios [HRs] with 95% confidence intervals (CIs) calculated (from univariate and stepwise multivariate models). Results: Median OS was 12.7 m (95% CI 8.0–17.4) and did not differ between IA [15.0 m (10.5-19.4)] and DA [11.7 m (4.1-19.3)]. 1 yr and 2 yr survival rates were similar (IA 42% and 21% vs. DA 44% and 23%). On univariate CPH analysis, factors associated with better OS were female gender, ECOG PS 0, absence of metastatic disease and receipt of maintenance pemetrexed CTx (mPEM) while current/ex-smoker status, disease progression (as best response) and age ≥70 years were a/w worse OS. Baseline Hb and homocysteine (both assessed as continuous variables) and receipt of packed RBC transfusions/ESAs for anemia correction did not influence OS. On multivariate CPH analysis, current/ex-smokers HR 2.2 (95% CI 1.3-3.7; p < 0.01) and mPEM HR 0.5 (95% CI 0.3-0.9; p = 0.01) were both significant. Median OS for current/ex-smokers was 7.4m (95% CI 5.4-9.4) vs. 25.6m (95% CI 16.2-35.0) for non-smokers (log rank p < 0.001) while for patients receiving mPEM, it was 22.7m (95% CI 9.9-35.4) vs. 9.7m (95% CI 4.9-14.5) for those not receiving mPEM (log rank p = 0.02). Conclusions: Smoking status and mPEM were strong and independent prognostic factors for OS in the PEMVITASTART trial. Clinical trial information: NCT02679443

 
Other Abstracts in this Sub-Category:

 

1. Association of STK11/LKB1 genomic alterations with lack of benefit from the addition of pembrolizumab to platinum doublet chemotherapy in non-squamous non-small cell lung cancer.

Meeting: 2019 ASCO Annual Meeting Abstract No: 102 First Author: Ferdinandos Skoulidis
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

2. Real-world outcomes of patients with advanced non-small cell lung cancer (aNSCLC) and autoimmune disease (AD) receiving immune checkpoint inhibitors (ICIs).

Meeting: 2019 ASCO Annual Meeting Abstract No: 110 First Author: Sean Khozin
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

3. RELAY: A multinational, double-blind, randomized Phase 3 study of erlotinib (ERL) in combination with ramucirumab (RAM) or placebo (PL) in previously untreated patients with epidermal growth factor receptor mutation-positive (EGFRm) metastatic non-small cell lung cancer (NSCLC).

Meeting: 2019 ASCO Annual Meeting Abstract No: 9000 First Author: Kazuhiko Nakagawa
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

More...