REPORTS FROM THE EUROPEAN CANCER CONFERENCELatest advances in cancer research highlighted at annual meeting
The 14th annual European Cancer Conference, sponsored by the European Cancer Organisation (ECCO), was held September 23- 27 in Barcelona, Spain. The results of numerous major clinical trials were presented, along with an increasing wealth of new preclinical and translational data. This exciting new information offers opportunities to consider new treatment approaches both in the research and practice settings.
ECCO is a consortium of societies and organizations involved in day-to- day oncology throughout Europe. ECCO seeks to take a wide approach to oncology—one that brings together major players in cancer research, treatment, and care in order to create awareness of patients’ wishes and needs; encourage progressive thinking in cancer policy, education, and training; and continue to promote European cancer research and its application through the multidisciplinary meetings and conferences.
ADVANCES IN LUNG CANCERGemcitabine Provides Efficacy Similar to Pemetrexed When Combined With Cisplatin for First-Line Treatment of Advanced NSCLC
Dr. Christian Manegold, Medical Center University of Mannheim, Interdisciplinary Thoracic Oncology, Mannheim, Germany, reported the results of a study evaluating pemetrexed (Alimta) plus cisplatin (PC; N=862) versus gemcitabine (Gemzar) plus cisplatin (GC; N=863) in chemonaive patients with locally advanced or metastatic non–small cell lung cancer (NSCLC). Patients in both arms received dexamethasone prophylaxis, folic acid, and vitamin B12 supplementation. Overall survival for patients randomized to PC was similar to that in those who received GC (10.3 months vs 10.3 months). Progression-free survival was also similar in the two arms (4.8 months in the PC group vs 5.1 months in the GC group).
The rates of Grade 3/4 hematologic toxicity were significantly lower (P
≤ 0.001) with PC than with GC, including neutropenia (15% vs 27%), anemia (6% vs 10%), and thrombocytopenia (4% vs 13%). Grade 3/4 febrile neutropenia (1% vs 4%) and alopecia (12% vs 21%) were also significantly (P
< 0.001) less common in the PC group. Less grade 3/4 nausea (7% vs 4%, P
= 0.004) and anorexia (2% vs 1%, P
= 0.009) were observed in the GC group. This study showed that for the first-line treatment of advanced NSCLC, PC provides efficacy similar to that of GC, with better tolerability (as well as more convenient administration) than GC.Gefitinib Is as Effective as Docetaxel in Patients with Pretreated Advanced NSCLC
Dr. Jean-Yves Douillard, Centre Rene Gauducheau, Site Hospitalier Nord, Nantes-Saint-Herblain, France, reported the results of the INTEREST (Iressa Non–Small-Cell Lung Cancer Trial Evaluating Response and Survival against Taxotere) trial— a Phase III, randomized, open-label, parallel-group study of oral gefi- tinib (Iressa) versus intravenous docetaxel (Taxotere) in patients with locally advanced or metastatic NSCLC who have previously received platinum-based chemotherapy. Dr. Douillard was Co- Principal Investigator and lead author of the study.
Patients ≥18 years of age with locally advanced or metastatic NSCLC that progressed or recurred following 1 or 2 prior chemotherapy regimens (≥1 of which were platinumbased) were randomized to receive either gefitinib (250 mg/day orally) or docetaxel (75 mg/m2
IV every 3 weeks). A total of 1466 patients were enrolled. Gefitinib-treated patients had survival equivalent to those treated with intravenous docetaxel. Gefitinib demonstrated a more favorable tolerability profile, and gefitinib-treated patients experienced superior quality of life for patients compared with docetaxel.
This is the largest Phase III study ever reported comparing two active treatments for pretreated, advanced NSCLC. It is also the first time an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), such as gefitinib, has demonstrated non-inferiority for overall survival relative to chemotherapy in a head-to-head Phase III study in patients with pretreated advanced NSCLC.
Dr. Edward Kim, Assistant Professor of Medicine, MD Anderson Cancer Center, Houston, Texas, and Co-Principal Investigator of the INTEREST study said, “This large study validates the role of targeted therapy when compared to chemotherapy in previously treated advanced NSCLC patients. The study showed that IRESSA was as effective as docetaxel but with a more favorable tolerability profile, resulting in significantly more IRESSA-treated patients experiencing clinically important improvements in quality of life compared with patients who received docetaxel. Clearly, improving efficacy while minimizing toxicity is the direction advanced cancer therapy is going.”Oral or IV Vinorelbine plus Cisplatin Achieves Efficacy Similar to That of Docetaxel plus Cisplatin in Chemonaïve Patients with Advanced NSCLC
The GLOB 3 trial was a multinational, randomized, Phase III trial of oral and IV vinorelbine (Navelbine) plus cisplatin versus docetaxel (Taxotere) plus cisplatin as first-line treatment for advanced NSCLC in chemonaive patients. Results of the GLOB 3 trial were reported by Dr. J. Rolski, Maria Curie Sklodowska Institute, Oncology, Krakow, Poland. Dr. Rolski was lead investigator and lead author of the study.