Click here to view as PDF.Global Oncology Community Reviews the Latest Advances in Cancer Research and New Innovations in Cancer Care
The American Society of Clinical Oncology (ASCO) held its 44th Annual Clinical Meeting in Chicago. Leading oncologists and cancer researchers at centers from around the world presented new basic and clinical research findings to advance the care of cancer.
The ASCO Annual Meeting is the premier scientific and educational event in the field of oncology, drawing more than 30,000 attendees from around the world. As a forum for collaboration and communication, the ASCO Annual Meeting brings together oncologists of all disciplines, researchers, nurses, and patient advocates in the fight against cancer. The 2008 meeting united the global oncology community with the common goals of delivering the highest quality patient care and innovating treatment advances.
Advances in Lung CancerPlatinum-Doublet Chemotherapy Followed by Gefitinib (Iressa) May Offer Improved Survival in Chemonaïve Patients With Advanced NSCLC
Toyoaki Hida, MD, PhD, who spoke on behalf of the West Japan Thoracic Oncology Group (WJTOG), presented the late-breaking results of a randomized phase III WJTOG study of platinum-doublet chemotherapy followed by gefitinib, a small molecule inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase, compared with continued platinum-doublet chemotherapy in patients with advanced non–small cell lung cancer (NSCLC).
Enrolled patients (N = 603) were chemotherapy-naïve, had advanced disease (stage IIIB or IV), had ECOG PS 0-1, and were randomized to receive either platinum-doublet chemotherapy for six cycles or platinumdoublet chemotherapy for three cycles followed by platinum-doublet chemotherapy.
Platinum-doublet chemotherapy consisted of one of the following regimens: (1) carboplatin AUC 6 + paclitaxel 200mg/m2
day1 q3w; (2) cisplatin 80 mg/m2
day1 + irinotecan 60 mg/ m2
days 1, 8, 15 q4W; (3) cisplatin 80 mg/m2
day 1 + vinorelbine 25 mg/m2
days 1, 8 q3W; (4) cisplatin 80 mg/m2
+ docetaxel 60 mg/m2
day 1 q3W; or (5) cisplatin 80 mg/m2
day 1 + gemcitabine 1000 mg/m2
days 1, 8 q3W. The primary endpoint was overall survival (OS).
There was a statistically significant improvement in progression-free survival (PFS) (hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.57-0.80; P
< 0.001) in the gefitinib group; however, OS result did not reach statistical significance. In a prespecified analysis of OS by histologic groups, the gefitinib group had significantly better OS than the continued platinum-doublet treatment group in adenocarcinoma histology (N = 467; HR, 0.79; 95% CI, 0.65-0.98;P
= 0.03). The investigators concluded that platinum-doublet chemotherapy followed by gefitinib may offer clinical benefit, particularly in patients with adenocarcinoma.First-line Sequential Administration of Erlotinib (Tarceva) With Chemotherapy Shows Promise in the Treatment of Stage IIIB/IV NSCLC: Results of the FAST-ACT
In a poster discussion, Jin S. Lee, MD, National Cancer Center, Seoul, South Korea, presented results of FAST-ACT—a phase II randomized, double-blind trial of sequential erlotinib and chemotherapy as first-line treatment in patients with stage IIIB/ IV NSCLC.
Study enrollees were chemonaïve and had an Eastern Cooperative Oncology Group performance status ECOG PS of 0-1. Patients were randomized to receive either erlotinib 150 mg/day (GC-E) or placebo (GC-P) on d 15-28 of 4-weekly chemotherapy cycles. Chemotherapy consisted of gemcitabine 1250 mg/m2
d1, eight plus either cisplatin 75 mg/m2
or carboplatin 5xAUC d1 for a maximum of six cycles. Responding pa- tients continued to receive erlotinib or placebo until progression or unacceptable toxicity. The primary endpoint was nonprogression rate (NPR: CR+PR+SD) at eight weeks based on Response Evaluation Criteria in Solid Tumors (RECIST).
A total of 154 patients from seven countries were enrolled. Median age was 57 years. Ninety- four percent of patients were Asian.
At eight weeks, the nonprogression rate was 80.3% and 76.9% in the erlotinib and placebo groups, respectively (P
= 0.51). At 16 weeks, the nonprogression rate in the two groups was 65.8% and 53.8%, respectively (P
= 0.11). Median progression-free survival (PFS) was 31.3 weeks in the erlotinib group, compared with 23.7 weeks in the placebo group (P
= 0.0175). The objective tumor response rate (based on partial responses) was 36.8% in the erlotinib group versus 24.4% in the placebo group (P
= 0.089). Median OS has not yet been reached.
The median number of treatment cycles received was 6 versus 5 (GC-E vs. GC-P). Rash-like events were noted in 66% of GC-E versus 35% of GC-P patients, and diarrhea was observed in 24% and 18% of patients in these groups, respectively. The most common grade 3–5 adverse events (GC-E vs. GC-P) were neutropenia (20% vs. 15%), anemia (8% vs. 6%), thrombocytopenia (5% vs. 5%), and vomiting (3% vs. 8%). Overall safety profiles were similar between the two groups.