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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIn patients with advanced nonsquamous non-small cell lung cancer (NSCLC), first-line treatment with pemetrexed plus carboplatin (PemC) followed by maintenance Pem is not associated with superior progression-free survival without Grade 4 toxicities compared with treatment with paclitaxel\/carboplatin\/bevacizumab (PCB) followed by maintenance bevacizumab. This article discusses the results of the Study of Patients With Advanced Non-Small Cell Lung Cancer [PRONOUNCE; NCT0948675; Zinner R et al. \u003Cem\u003EJ Clin Oncol\u003C\/em\u003E 2013 (suppl; abstr LBA8003)], a randomized, open-label, Phase 3 study that assessed the superiority of 2-drug regimen PemC compared with 3-drug regimen PCB in patients with advanced NSCLC.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECancer\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ERespiratory Cancers\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECancer\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ERespiratory Cancers\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIn patients with advanced nonsquamous non-small cell lung cancer (NSCLC), first-line treatment with pemetrexed plus carboplatin (PemC) followed by maintenance Pem is not associated with superior progression-free survival without Grade 4 toxicities (G4PFS) compared with treatment with paclitaxel\/carboplatin\/bevacizumab (PCB) followed by maintenance bevacizumab (BEV).\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ERalph Zinner, MD, University of Texas MD Anderson Cancer Center, Houston, Texas, USA, presented the results of the Study of Patients With Advanced Non-Small Cell Lung Cancer [PRONOUNCE; NCT0948675; Zinner R et al. \u003Cem\u003EJ Clin Oncol\u003C\/em\u003E 2013 (suppl; abstr LBA8003)], a randomized, open-label, Phase 3 study that assessed the superiority of 2-drug regimen PemC compared with 3-drug regimen PCB in patients with advanced NSCLC.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EA total of 361 patients were enrolled in the study, all of who met the eligibility criteria: age \u226518 years, stage IV NSCLC, an ECOG PS of 0 to 1, chemotherapy-na\u00efve status, and stable treated central nervous system metastases. Patients with uncontrolled effusions were excluded from the study.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EOf the 361 patients, 182 were randomized to PemC and 179 to PCB. Patients in both arms received 4 cycles of induction therapy followed by maintenance therapy in the absence of progressive disease or discontinuation of therapy. The PemC group received 4 cycles of induction Pem (500 mg\/m\u003Csup\u003E2\u003C\/sup\u003E) and CBP (area under the curve [AUC]=6) followed by Pem maintenance therapy, and the PCB group received induction paclitaxel (200 mg\/m\u003Csup\u003E2\u003C\/sup\u003E), CBP (AUC=6), and BEV (15 mg\/kg) followed by BEV maintenance therapy.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EBaseline characteristics were similar between the two treatment groups, with a median age of 66 years, 42% female, the majority Caucasian, 47% ECOG PS 0, and 70% disease stage M1b.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe primary endpoint of the study was a composite endpoint of G4PFS. Secondary endpoints included PFS, overall survival (OS), response rates (RR), disease-control rates (DCR), and safety\/tolerability.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EBased on an intention-to-treat analysis, the study found no difference in G4PFS between PemC and PCB (median 3.9 vs 2.9 months; HR, 0.85; 90% CI, 0.70 to 1.04; log-rank p=0.176).\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EIn addition, the study found no differences between PemC and PCB in PFS (median 4.4 vs 5.5 months; HR, 1.06; 95% CI, 0.84 to 1.35; log-rank p=0.610), OS (median 10.5 vs 11.7 months; HR, 1.07; 95% CI, 0.83 to 1.36; log-rank p=0.616), RR (23.6% vs 27.4%; p=0.414), or DCR (59.9% vs 57.0%; p=0.575).\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EBased on the actual study regimen of 171 patients treated with PemC and 166 treated with PCB, the study found that the PemC group had significantly more drug-related Grade 3\/4 anemia (18.7% vs 5.4%; p\u0026lt;0.001) and thrombocytopenia (24.0% vs 9.6%; p\u0026lt;0.001). Patients treated with PCB had significantly more drug-related Grade 3\/4 neutropenia than the PemC group (48.8% vs 24.6%; p\u0026lt;0.001) and Grade 1 and Grade 2 alopecia (16.3% vs 5.8%;p=0.003; and 12.0% vs 2.3%; p\u0026lt;0.001, respectively).\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EAccording to the investigators, there were no unexpected toxicities and both treatments demonstrated tolerability.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/6\/23.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznwc2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}