Prospective Observational Cohort Study of Second-Line Chemotherapy Administration After the First-Line Platinum-Based Chemotherapy for Patients with Advanced Nsclc in Japan (Sapphire Study): Update Analysis

Abstract

ABSTRACT Aim: The standard therapy of advanced non-small cell lung cancer (NSCLC), is first-line platinum-based chemotherapy (first CT) and second-line chemotherapy (second CT) after the progression of the first- CT. This study is to survey the proportion of those who actually received the second-CT with or without maintenance chemotherapy, and to find the factors associated with its administration. Methods: Patients with advanced NSCLC who received platinum-based first- CT from April 2010 to September 2011, at 30 institutions in Japan were recruited. Baseline characteristics, contents of first/second/third-line CT, administration of maintenance CT and reason for not receiving second- CT were obtained. This is an update report for April 2014. The Public Health Research Foundation CSPOR supported this study. Results: A total of 865 eligible patients provided patient characteristics and details of the first- CT. Primary study population was 570 patients who had CR/PR/SD in the first- CT and was analyzed of the administration of the second-CT. Maintenance therapy was administered to 194 patients. Of those, 185 patients progressed and 32 patients could not receive second- CT. Observation with no maintenance therapy was done in 392 patients. Of those, 385 patients progressed and 112 patients could not receive second- CT. Decline of PS was the principal reason for not receiving second- CT in both groups with and without maintenance CT. Switch compared with continuation maintenance therapy, and presence compared with absence of the comorbidity were the only factors associated with opportunity loss of the second- CT in the maintenance and observational groups, respectively. Conclusions: This study suggested that the 28.1 % of patients who did not received second- CT missed an opportunity to receive appropriate second- CT, compared with 17.3% who received maintenance therapy. Administration of maintenance therapy did not appear to compromise the chance to receive second- CT. Switch maintenance therapy is more likely to miss the opportunity for the second- CT than continuation maintenance therapy. Disclosure: Y. Goto: Received honoraria from: Eli Lilly, Taiho, Chugai, AstraZeneca; H. Kunitoh: Received honoraria from: Eli Lilly, Taiho, Chugai, AstraZeneca, Sanofi. All other authors have declared no conflicts of interest.