1294P Real world data of practice patterns and outcomes for pemetrexed plus platinum as neoadjuvant chemotherapy in adenocarcinomas of lung from a tertiary cancer center of India: Looking beyond the usual paradigm (Record no. 82501)

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fixed length control field 03313nab a22002777a 4500
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fixed length control field 171107b2017 xxu||||| |||| 00| 0 eng d
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Kapoor A
245 ## - TITLE STATEMENT
Title 1294P Real world data of practice patterns and outcomes for pemetrexed plus platinum as neoadjuvant chemotherapy in adenocarcinomas of lung from a tertiary cancer center of India: Looking beyond the usual paradigm
260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT)
Date of publication, distribution, etc 2017
300 ## - PHYSICAL DESCRIPTION
Extent
520 ## - SUMMARY, ETC.
Summary, etc Background: Neoadjuvant chemotherapy (NACT) is the standard of care in non-small cell lung cancers (NSCLC) with locally advanced N2 disease. There is scarcity of data for pemetrexed-platinum regimen as NACT. Also, aside from N2 disease, role of NACT in locally advanced NSCLCs for tumor downstaging is unclear.

Methods: Nonmetastatic adenocarcinomas of lung treated with pemetrexed-platinum based NACT were analysed. The patients with locoregionally advanced N2 disease and those who were borderline candidates for upfront definitive treatment were planned for NACT after discussion in a multidisciplinary clinic. Total 4 cycles of 3-weekly pemetrexed and platinum were delivered in combined neoadjuvant and adjuvant setting. Response assessment was done using RECIST criteria. Progression free (PFS) and overall survival (OS) were calculated using Kaplan Meier method.

Results: Out of 114 evaluable patients, 99 patients received NACT with pemetrexed-platinum. Most common indication for NACT was N2 disease at baseline (46.4%). Objective response rate was 38.2% (95% CI: 23%-53%) including two complete and 34 partial responses. 12.7% patients had progressive disease on NACT. Median PFS was 15 months (95% CI 11.6-18.4) and median OS was 22 months (95% CI 15.6-28.3) at a median follow-up of 16 months. There was a significant improvement in the OS of patients undergoing definitive therapy versus no definitive therapy (median OS 25 months [95% CI 19.4-30.3] vs 12 months [95% CI 3.2-20.3] respectively; p = 0.047, HR 1.6). Amongst patients who could not undergo definitive CTRT upfront due to dosimetric constraints (n = 36), 26 (72.2%) patients finally underwent CTRT after NACT. Those patients who were not able to undergo definitive CTRT had median PFS of 5 months [95% CI 2.1-7.9] versus 10 months [95% CI 3.8-16.1] in those who were made amenable to definitive CTRT post NACT; p = 0.018.

Conclusions: Pemetrexed-platinum based NACT appears to be an effective option and many borderline cases where upfront definitive therapy is not feasible may become amenable to the same after incorporation of NACT.

Clinical trial identification: Clinical Trials Registry India (registration number: CTRI/2013/01/003335)

Legal entity responsible for the study: Tata Memorial Hospital, Mumbai

Funding: None

Disclosure: All authors have declared no conflicts of interest.
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name as entry element Adenocarcinoma
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name as entry element Neoadjuvant chemotherapy
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name as entry element Lung Cancer
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Zanwar S
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Personal name Joshi A
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Personal name Noronha V
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Personal name Patil V
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Chougule A
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Mahajan A
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Bhargava P
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Prabhash K
773 ## - HOST ITEM ENTRY
Main entry heading Annals of Oncology
Place, publisher, and date of publication London : Oxford University Press, 2017
Relationship information Vol. 28, no. suppl_5, p.459.
International Standard Serial Number 0923-7534
906 ## - LOCAL DATA ELEMENT F, LDF (RLIN)
Dept Medical Oncology
Corporate name TMC
Article Type Conference Abstract
Country type International
Added Entry TMH
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Item type Articles
Holdings
Withdrawn status Lost status Source of classification or shelving scheme Damaged status Not for loan Permanent location Current location Date acquired Barcode Date last seen Koha item type
          Tata Memorial Hospital Tata Memorial Hospital 2017-11-07 AR18620 2017-11-07 Articles

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