Real-World Evidence: Multicenter Efficacy and Toxicity Analysis of Nintedanib With Docetaxel as Second-Line Treatment in Mexican Patients With Advanced Lung Adenocarcinoma

Author:

Rodríguez-Cid Jeronimo Rafael1,Campos-Gomez Saul2,García-Montes Vanessa3,Magallanes-Maciel Manuel4,Flores-Mariñelarena Rodrigo Rafael5,Fernández-Garibay Valeria Michelle6,González-Espinoza Iván Romarico7,Ceja-García Juan Paulo8,Cázarez-Price Juan Carlos9,Martínez-Barrera Luis1,Barriguete-Parra Leopoldo10,Zuloaga-Fernandez Carlos Jose11,Kuri-Exsome Roberto12,Suárez-García David13,Gonzalez-Villanueva Jorge Ignacio14,Flores-Anaya Noé15,Acevedo-Delgado Jose Antonio16,Astorga-Ramos Alma Magdalena17,Gerson-Cwilich Raquel9,Villalobos-Prieto Alberto9,Rodríguez-Silva Claudia18,Noriega-Iriondo Maria Fernanda19,Vázquez-Cortés Leticia20,Perales-Rodríguez Eusebio21,Acosta-Espinoza Alicia22,Perez-Lozano Yareni23,Capdeville-García Daniel12,Alatorre-Alexander Jorge Arturo1

Affiliation:

1. Department of Oncology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico

2. Department of Oncology, Centro Oncológico Estatal ISSEMYM, State of Mexico, Toluca de Lerdo, Mexico

3. Department of Oncology, Hospital Español, Mexico City, Mexico

4. Department of Oncology, Hospital Central Militar, Mexico City, Mexico

5. Department of Internal Medicine, Fundación Clínica Médica Sur, Mexico City, Mexico

6. School of Medicine, Monterrey Institute of Technology and Higher Education, Mexico City, Mexico

7. Department of Oncology, Hospital Ángeles Puebla, Puebla, Mexico

8. Department of Oncology, Hospital General ISSSTE La Paz, Baja California Sur, Mexico

9. Department of Oncology, American British Cowdray Medical Center, Mexico City, Mexico

10. Department of Oncology, Centro Oncológico de Chihuahua, Chihuahua, Mexico

11. Department of Oncology, Oncología Privada Integral, Guadalajara, Mexico

12. Department of Oncology, Hospital Aranda de la Parra, Guanajuato, Mexico

13. Department of Oncology, Seguro Popular, León, Mexico

14. Department of Oncology, Oncare Treatment Center, Monterrey, Mexico

15. Department of Oncology, Medionco, Mexico City, Mexico

16. Department of Oncology, Unidad de Cancerología, Jalisco, Mexico

17. Department of Oncology, Sanatorio San José, Monterrey, Mexico

18. Department of Oncology, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico

19. Department of Oncology, Centro Médico Hospital San José, Monterrey, Mexico

20. Department of Oncology, Clínica Médica ARCOS, Morelia, Mexico

21. Department of Oncology, Servicio de Salud Pemex, Reynosa, Mexico

22. Department of Oncology, Hospital ISSSTE Mexicali, Baja California, Mexico

23. Department of Oncology, Hospital Puebla, Puebla, Mexico

Abstract

PURPOSE The LUME-Lung 1 study has brought consistent evidence of the effective use of nintedanib in lung adenocarcinoma as a second line of treatment; however, differences among ethnicities have been found in some studies. METHODS This was a retrospective review among 21 medical centers of 150 patients with a confirmed diagnosis of lung adenocarcinoma, included in a compassionate use program of nintedanib from March 2014 to September 2015. The current study aimed to analyze the effectiveness of nintedanib in combination with docetaxel in the Mexican population, using progression-free survival rate and the best objective response to treatment by RECIST 1.1 as a surrogate of effectiveness. In addition, we examined the toxicity profile of our study population as a secondary end point. RESULTS After exclusion criteria, only 99 patients met the criteria for enrollment in the current study. From the total study population, 53 patients (53.5%) were male and 46 (46.5%) were female, with an average age of 60 years and stage IV as the most prevalent clinical stage at the beginning of the compassionate use program. A total of 48 patients (48.5%) had partial response; 26 (26.3%), stable disease; 4 (4%), complete response; and 16 (16.2%), progression; and 5 (5%) were nonevaluable. We found a median progression-free survival of 5 months (95% CI, 4.3 to 5.7 months). The most common grade 3 or 4 adverse reactions were fatigue (14%) and diarrhea (13%). CONCLUSION Nintedanib, as part of a chemotherapy regimen, is an effective option with an acceptable toxicity profile for advanced lung adenocarcinoma after first-line treatment progression.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

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