holder: AstraZeneca. All other authors have declared no conflicts of interest. 137O Nivolumab in patients (pts) with advanced refractory squamous (SQ) non-small cell lung cancer (NSCLC): 2-year follow-up from CheckMate 063 and exploratory cytokine profiling analyses
on days 1, 8, and 15 of a 21-day cycle. The primary end point was overall survival analyzed on an intention-totreat basis. Adverse events were assessed according to treatment received. Results: Between 22 May 2015 and 12 March 2018, 503 patients were randomly allocated to treatment. Median overall survival was 13.6 months (95% CI, 10.9e16.5) for the 251 patients allocated to docetaxel and 16.2 months (95% CI, 14.4e19.0) for the 252 patients allocated to nab-paclitaxel (hazard ratio, 0.85; 95.2% CI, 0.68e1.07). Median progression-free survival was 4.2 months (95% CI, 3.9e5.0) for the nab-paclitaxel group versus 3.4 months (95% CI, 2.9e4.1) for the docetaxel group (hazard ratio, 0.76; 95% CI, 0.63e0.92; p¼0.0042). The objective response rate was 29.9% (95% CI, 24.0e36.2) for the nab-paclitaxel group and 15.4% (95% CI, 10.9e20.7) for the docetaxel group (p¼0.0002), and it showed a significant improvement for nabpaclitaxel versus docetaxel regardless of tumor histology. Adverse events of grade 3 included febrile neutropenia (55 [22%] of 249 patients in the docetaxel group versus 5 [2%] of 245 patients in the nab-paclitaxel group) and peripheral sensory neuropathy (2 [1%] versus 24 [10%], respectively). Conclusion: The trial showed that nabpaclitaxel was noninferior to docetaxel in terms of overall survival. Nab-paclitaxel should thus be considered a standard treatment option for previously treated patients with advanced NSCLC.
Few data are available that have compared outcomes with different EGFR tyrosine kinase inhibitors (TKIs) specifically in Asian patients with EGFR mutation-positive non-small-cell lung cancer. In this narrative review, we have collated available data from prospective studies that have assessed first-, second- and third-generation EGFR TKIs in Asian populations, including subanalyses in individual countries (China and Japan). These data indicate that outcomes with first- and second-generation TKIs are broadly similar in Asian and non-Asian populations. However, while the third-generation EGFR TKI, osimertinib, confers significant overall survival benefit over erlotinib/gefitinib in non-Asians, this is not apparent in Asians, particularly in countries like Japan with well-resourced healthcare. Head-to-head comparisons of second- and third-generation EGFR TKIs, with OS as a primary end point, should be considered in Asia.
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