TY - JOUR
T1 - Association between depth of response and survival in patients with advanced-stage non–small cell lung cancer treated with first-line chemotherapy
AU - Morgensztern, Daniel
AU - Ko, Amy
AU - O’Brien, Mary
AU - Ong, Teng Jin
AU - Waqar, Saiama N.
AU - Socinski, Mark A.
AU - Postmus, Pieter E.
AU - Bhore, Rafia
N1 - Funding Information:
Editorial support was provided by MediTech Media, Ltd, and was funded by Celgene Corporation.
Funding Information:
Daniel Morgensztern reports receiving personal fees from Celgene, AbbVie, Bristol-Myers Squibb, Takeda, and PharmaMar and being an institutional principal investigator for studies from Roche, Heat Biologics, EpicentRx, Incyte, AstraZeneca, and Novartis. Teng Jin Ong and Rafia Bhore report employment by or a leadership position at Celgene and ownership of Celgene stock. Saiama N. Waqar reports receiving funding from the National Institutes of Health (grant 1 UM1 CA186704-01) and being an institutional principal investigator for studies from F. Hoffmann?La Roche, Ltd, Ariad, Pfizer Pharmaceuticals, Inc, Hengrui Therapeutics, Xcovery, EMD Serono Research & Development Institute, Inc, Checkpoint Therapeutics, Inc, Genentech, Inc, Lilly, Stemcentrx, Inc, Ignyta, Inc, Bristol-Myers Squibb, Synermore Biologics Co, Ltd, Novartis Pharmaceuticals Corporation, Merck & Company, Inc, NewLink Genetics Corporation, and Celgene. Pieter E. Postmus reports personal fees from Celgene, Bristol-Myers Squibb, Roche, MSD, AstraZeneca, Novartis, Boehringer Ingelheim, Eli Lilly, G1 Therapeutics, Janssen, and AbbVie and funding from Boehringer Ingelheim. The other authors made no disclosures. Celgene sponsored the study and was involved in the study design, data collection, and data analysis. All the authors had full access to all collected data and had sole discretion in the data interpretation, writing of the report, and decision to submit for publication. The corresponding author had full access to all data in the study and had final responsibility for the decision to submit the study for publication.
Publisher Copyright:
© 2019 American Cancer Society
PY - 2019/7/15
Y1 - 2019/7/15
N2 - Background: A partial response according to the Response Evaluation Criteria in Solid Tumors includes a wide range of changes in tumor size. This study evaluated whether further specification of tumor reduction based on the depth of response (DpR) would provide a more precise association with outcomes for patients with non–small cell lung cancer (NSCLC) treated with first-line platinum-based chemotherapy. Methods: A retrospective analysis was performed for the randomized phase 3 CA031 trial in patients with NSCLC treated with carboplatin in combination with nab-paclitaxel or solvent-based paclitaxel. Quartiles according to the maximum tumor reduction from the baseline were defined (quartile 1 [Q1], >0% to 25%; quartile 2 [Q2], >25% to 50%; quartile 3 [Q3], >50% to 75%; and quartile 4 [Q4], >75%) and were compared with those patients with no tumor reduction (NTR). The primary objective was to evaluate the association between DpR and overall survival (OS). Results: Of the 1052 patients enrolled in the CA031 trial, 959 (91%) were evaluable, and they included 365 (38.1%) who were classified as Q1, 327 (34.1%) who were classified as Q2, 131 (13.7%) who were classified as Q3, and 34 (3.5%) who were classified as Q4; 102 had NTR (10.6%). The median OS values for patients in the NTR, Q1, Q2, Q3, and Q4 groups were 4.8, 10.4, 14.5, 19.3, and 23.5 months, respectively. The maximum DpR on treatment was an independent predictor of improved OS in comparison with patients with NTR; the hazard ratio decreased from 0.43 in Q1 to 0.16 in Q4. Conclusions: DpR was strongly associated with OS in patients with NSCLC receiving first-line platinum-based therapy. Additional studies may help to define the role of DpR in solid tumors.
AB - Background: A partial response according to the Response Evaluation Criteria in Solid Tumors includes a wide range of changes in tumor size. This study evaluated whether further specification of tumor reduction based on the depth of response (DpR) would provide a more precise association with outcomes for patients with non–small cell lung cancer (NSCLC) treated with first-line platinum-based chemotherapy. Methods: A retrospective analysis was performed for the randomized phase 3 CA031 trial in patients with NSCLC treated with carboplatin in combination with nab-paclitaxel or solvent-based paclitaxel. Quartiles according to the maximum tumor reduction from the baseline were defined (quartile 1 [Q1], >0% to 25%; quartile 2 [Q2], >25% to 50%; quartile 3 [Q3], >50% to 75%; and quartile 4 [Q4], >75%) and were compared with those patients with no tumor reduction (NTR). The primary objective was to evaluate the association between DpR and overall survival (OS). Results: Of the 1052 patients enrolled in the CA031 trial, 959 (91%) were evaluable, and they included 365 (38.1%) who were classified as Q1, 327 (34.1%) who were classified as Q2, 131 (13.7%) who were classified as Q3, and 34 (3.5%) who were classified as Q4; 102 had NTR (10.6%). The median OS values for patients in the NTR, Q1, Q2, Q3, and Q4 groups were 4.8, 10.4, 14.5, 19.3, and 23.5 months, respectively. The maximum DpR on treatment was an independent predictor of improved OS in comparison with patients with NTR; the hazard ratio decreased from 0.43 in Q1 to 0.16 in Q4. Conclusions: DpR was strongly associated with OS in patients with NSCLC receiving first-line platinum-based therapy. Additional studies may help to define the role of DpR in solid tumors.
KW - Response Evaluation Criteria in Solid Tumors (RECIST)
KW - depth of response
KW - first-line chemotherapy
KW - non–small cell lung cancer (NSCLC)
KW - overall survival
UR - http://www.scopus.com/inward/record.url?scp=85063669332&partnerID=8YFLogxK
U2 - 10.1002/cncr.32114
DO - 10.1002/cncr.32114
M3 - Article
C2 - 30933354
AN - SCOPUS:85063669332
SN - 0008-543X
VL - 125
SP - 2394
EP - 2399
JO - Cancer
JF - Cancer
IS - 14
ER -