Thoracic Cancer

Abstract

Aim/Background: First-line A significantly improved progression-free survival (PFS) vs CT in pts with EGFR mutation-positive NSCLC in the LL3 and LL6 trials (LL3: 11.1 vs 6.9 months, HR 0.58; p<0.001; LL6: 11.0 vs 5.6 months, HR 0.28; p<0.0001). Overall survival (OS) was significantly improved with Avs CT in pts with Del19 mutations (LL3: 33.3 vs 21.1 months, HR 0.54, p=0.0015; LL6: 31.4 vs 18.4 months, HR 0.64, p=0.023). The efficacyand safetyof Avs CT in pts aged ≥ 65 years in the LL3 and LL6 trials are reported. Methods: Pts with EGFR mutation-positive stage IIIB or IV NSCLC (345 in LL3 and 364 in LL6) were randomized 2:1 to oral A (40 mg/day) or up to 6 cycles of CT (LL3: cisplatin/pemetrexed; LL6: cisplatin/gemcitabine). Pts were stratified by EGFR mutation (Del19/L858R/other) and race (LL3 only; Asian/non-Asian). Analyses byage (<65, ≥ 65) were pre-specified for both trials, analyses byagewithin mutation subgroups were post-hoc. Results: In LL3 and LL6, 134 and 86 pts aged ≥ 65 years, respectively,were randomized. PFS was significantly improved with Avs CT in these pts (LL3: 13.6 vs 8.2 months, HR 0.60 [95% CI 0.37 – 0.96], p=0.03; LL6: 13.1 vs 4.1 months, HR 0.17 [95% CI 0.07 – 0.41], p<0.0001). OS was similar with Avs CT in all pts aged ≥ 65 years, with atrend towards improved OS with Avs CT noted in those with common EGFR mutations (LL3: 31.6 vs 24.9 months; HR 0.73