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- W2590604906 abstract "e18047 Background: In NSCLC patients with adenocarcinoma or large cell carcinoma, symptomatic BM frequently occur following treatment. Considering the particular activity of P in nonsquamous NSCLC, we retrospectively analyzed two large randomized trials to determine the investigators' reported pattern of symptomatic relapse in the brain. Methods: Two large, phase III studies of P in advanced NSCLC were included in this retrospective analysis. One study (N = 1725) tested cisplatin plus P versus cisplatin plus gemcitabine in chemotherapy-naive patients with advanced NSCLC (Scagliotti JCO 2008) and the other (N = 571) tested P versus docetaxel in previously treated patients (Hanna JCO 2004). Patients (pts) with known BM at study entry were excluded. Each study was analyzed separately to determine the rate of BM reported as the only site of progressive disease (PD) by treatment group and histology. Logistic regression was used to obtain an odds ratio (OR) for the treatment effect on BM while controlling for potential confounding factors. Results: Overall, 71.5% of pts in P-containing arms (819 of 1145) and 68.2% of pts in non-P-containing arms (785 of 1151) experienced PD. BM relapse rates by treatment arm, study, and histologic subgroup are summarized below (Table). Conclusions: Nonsquamous advanced NSCLC pts treated with P either in first-line or second-line in phase III studies may have reduced risk of developing BM as the first site of PD. This retrospective analysis is limited due to the lack of prospectively performed, periodic brain CT scans; therefore this analysis reflects symptomatic BM only. Nonetheless, these findings may imply a possible positive effect on the control of BM with P in the nonsquamous population. BM relapse rates P-containing arms Non-P-containing arms Fisher's exact P value Overall (both studies) 3.2% (26 of 819) 6.6% (52 of 785) 0.002 Scagliotti study only 3.6% (22 of 621) 6.5% (39 of 604) 0.025 Hanna study only 2.0% (4 of 198) 7.2% (13 of 181) 0.023 All nonsquamous pts (both studies) 3.0% (18 of 602) 7.3% (42 of 577) <0.001 All squamous pts (both studies) 3.7% (8 of 217) 4.8% (10 of 208) 0.635 OR for treatment effect of P (95% confidence intervals) 0.494 (0.32, 0.75) Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Lilly Lilly" @default.
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- W2590604906 date "2010-05-20" @default.
- W2590604906 modified "2023-09-26" @default.
- W2590604906 title "Brain metastases (BM) as the primary site of relapse in two randomized phase III pemetrexed (P) trials in advanced non-small cell lung cancer (NSCLC)." @default.
- W2590604906 doi "https://doi.org/10.1200/jco.2010.28.15_suppl.e18047" @default.
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