|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.
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.”
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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.