The following article features coverage from the American Society of Clinical Oncology 2019 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Researchers shared phase 3 data on the efficacy of continuation maintenance treatment after induction therapy in patients with advanced non-squamous non−small cell lung cancer (nSQ-NSCLC) during the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois.

In the COMPASS study, 907 participants with no prior history of treatment for advanced nSQ-NSCLC, received induction therapy consisting of carboplatin (CAB) AUC 6 + pemetrexed 500 mg/m2 (PEM) + bevacizumab 15 mg/kg (BEV) every 3 weeks for 4 cycles.

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Patients who had no progression during induction were randomly selected in a 1:1 ratio to receive maintenance therapy with either BEV alone (295 individuals) or BEV+PEM (299 individuals). Among the participants, the median patient age was 65 years, 28% were female, 83% had stage 4 disease, Eastern Cooperative Oncology Group (ECOG) performance score was 0 in 60% and 1 in 40%. In addition, the status of EGFR among the participants was either wild-type (91%), not Del19 nor L858R, or unknown (7%).

Interestingly, there was no significant difference in median overall survival (OS) between the BEV+PEM group (23.3 months) and BEV group (19.6 months); hazard ratio (HR) was reported as 0.87 (95% CI, 0.73-1.05; one-sided log rank P =.069).

The hazard ratio for OS in patients with EGFR wild-type nSQ-NSCLC was 0.82 (95% CI, 0.68-0.99). And median progression-free survival was reported to be 5.7 months with BEV+PEM vs 4.0 months with BEV (HR, 0.67; 95% CI, 0.57-0.79).

Subsequent therapy was prescribed for a majority of patients (87.4%). No unusual safety concerns arose during the study.

The authors concluded that, “The primary analysis was not met. However, the incorporation of PEM significantly prolonged OS in patients with wild-type EGFR.” They also added that in this subset of individuals or in patients aged younger than 70 years, “BEV+PEM continuation maintenance after CAR+PEM+BEV induction chemotherapy could have survival benefits.”

Read more of Cancer Therapy Advisor‘s coverage of ASCO’s annual meeting by visiting the conference page.

Reference

Seto T, Azuma K, Yamanaka T, et al. A randomized phase III study of continuous maintenance bevacizumab with or without pemetrexed after induction therapy with carboplatin (Car), pemetrexed (Pem), and bevacizumab (Bev) for advanced non-squamous non-small cell lung cancer (nSQ-NSCLC) without sensitizing EGFR mutations: The COMPASS study (WJOG5610L). Presented at: 2019 American Society of Clinical Oncology (ASCO) Annual Meeting; May 31-June 3, 2019; Chicago, IL. Abstract 9003.