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Multicenter, prospective, randomized, phase-II trial of sequential and concurrent oral bexarotene in combination with chemotherapy, in previously untreated patients with advanced NSCLC.
R. Bordoni, G. Volas-Redd, L. Zemsky, M. Saleh, C. Powell, S. Harris;
Georgia Cancer Specialists, Marietta, GA; Georgia Cancer Specialists, Atlanta, GA; Marietta Pulmonary, Marietta, GA; Georgia Lung Associates, Marietta, GA
Abstract: Background: Recent Phase III trials have failed to show significant differences in survival for patients with Stage IIIB/IV NSCLC treated with various platinum-based chemotherapy regimens.
New effective therapies are still needed. Bexarotene (Targretin), a synthetic retinoid analogue approved for patients with cutaneous T-cell lymphoma, binds preferentially to the rexinoid receptor (RXR), potentially providing therapeutic benefits in RXR-expressing tumors.
Phase I-II studies of bexarotene in advanced NSCLC have shown promising activity.
Methods: Chemotherapy-naïve patients with Stage IV and IIIB with pleural effusion, and ECOG performance status (PS) 0-2, were enrolled on study and treated with carboplatin IV AUC-6 Day 1 and paclitaxel IV 100 mg/m2 Days 1, 8 and 15, every 28 days for up to 4 cycles.
Patients were randomized to receive bexarotene orally 400 mg/m2/day either concurrently with chemotherapy from Day 1 or sequentially at the completion of the chemotherapy. Patients were started an antilipid agent 7 days prior to bexarotene therapy.
Results: 16 patients (median age 67 years) have been enrolled thus far, 9 of whom have completed the planned 4 cycles of chemotherapy (5 in the sequential and 4 in the concurrent arm). Three patients remain on active therapy and 13 patients are off trial; 6 due to progressive disease, 3 for deteriorating PS, 3 for bexarotene-associated adverse events (AE) and 1 withdrew.
Overall, AE were reported in 48% of patients in the sequential arm vs. 51% in the concurrent arm. The incidence of Grade 3-4 AE, regardless of the treatment arm or phase, was < 5%. There were no cases of pancreatitis and no treatment-associated deaths.
Conclusions: Our data indicate no detrimental effect of adding bexarotene to weekly carboplatin/paclitaxel. Updated data will be presented at the meeting.
Abstract No: 7353
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 Abstract # 7358
ASCO, 2004

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