AN INVESTIGATION INTO P/B-MAINTENANCE THERAPY FOLLOWING COMBINED THERAPY WITH CARBOPLATIN (C) + PEMETREXED (P) + BEVACIZUMAB (B) AS THE PRIMARY TREATMENT AGAINST NON-SQ NSCLC

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Abstract

Background

After performing the PARAMOUNT study, the significant prolongation of PFS was observed when conducting maintenance therapy with the single agent of P alone following cisplatin (CDDP) + P therapy. Upon an AVAPERL study, P/B-maintenance therapy exhibited a better PFS than the single agent of B alone following CDDP/P/B.

Purpose

The safety and efficacy was investigated regarding conducting P/B-maintenance therapy following primary treatment with C/P/B.

Methods

C AUC 5 + P 500 mg/m2 + B 15 mg/kg were administered in 3-week intervals at a maximum of six courses to PS 0–3, stage IV, non-Sq NSCLC patients of ≥20 with no history of prior treatment who maintained adequate organ function. Maintenance therapy with P/B was conducted in non-PD cases at 3-week intervals until they became PD.

Outcome

There were seven cases (December 2009 to November 2010) of men/women: 5/2, with a median age of 64 years old (47–76), PS 0/1/3: 2/3/2 and adenocarcinoma/large cell carcinoma: 6/1. The antitumor effect was: CR/PR/SD/PD: 0/5/1/1, RR = 71%, median PFS = 8.9 M and OS = 15 M, which was slightly better compared with the RR = 66%, PFS = 8.4 M of 17 cases that simultaneously underwent P following C/P in our institute. Regarding toxicity, neutropenia with G2 or more tended to be common compared with the C/P group, but other hematotoxicities were to the same extent. Two cases of G2 hypertension and one case of G2 ILD were observed with non-hematological toxicity, but it was rapidly improved by steroids. Among the seven cases, six cases completed the six courses of C/P/B, then switched over to P/B-maintenance therapy.

Conclusion

C/P/B therapy exhibited high safety and efficacy, thus suggesting that it may become one regimen for the primary treatment of non-Sq NSCLC.

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