Dr. Fidler on Novel Chemotherapy Strategies in Nonsquamous NSCLC

Mary J. Fidler, MD, associate professor, Rush University Medical Center, discusses progression-free survival (PFS) and overall survival (OS) in patients with stage IV, nonsquamous, non—small cell lung cancer (NSCLC) treated with first-line pemetrexed (Alimta) and platinum followed by pemetrexed maintenance.

Patients in the study had stage IV nonsquamous NSCLC and received at least one cycle of pemetrexed and platinum-based chemotherapy between May 2010 and November 2013. The PFS rate at years 1, 2, 3, 4, and 5 were 33%, 14%, 7.5%, 4%, and 3%. OS from years 1 to 5 was 54.5%, 36%, 21%, 14%, and 11%, respectively. A lower baseline neutrophil, as assessed by lymphocyte ratio, hemoglobin, and albumin were associated with better PFS.

The study found that patients with better PFS and OS had favorable baseline prognostic indicators; therefore, this patient subset might benefit from the recently approved regimen of frontline pembrolizumab (Keytruda) with pemetrexed and platinum-based chemotherapy.