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SATURN: A double-blind, randomized, phase III study of maintenance erlotinib versus placebo following nonprogression with first-line platinum-based chemotherapy in patients with advanced NSCLC.

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Sub-category:
Metastatic Lung Cancer

Category:
Lung Cancer--Metastatic Lung Cancer

Meeting:
2009 ASCO Annual Meeting

Abstract No:
8001

Citation:
J Clin Oncol 27:15s, 2009 (suppl; abstr 8001)

Author(s):
F. Cappuzzo, T. Ciuleanu, L. Stelmakh, S. Cicenas, A. Szczesna, E. Juhasz, E. Esteban Gonzalez, O. Molinier, G. Klingelschmitt, G. Giaccone, on behalf of the SATURN Investigators; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institute of Oncology Ion Chiricuta, Cluj-Napoca, Romania; Pavlov State Medical University, St. Petersburg, Russian Federation; Institute of Oncology, Vilnius University, Vilnius, Lithuania; Mazowieckie Centrum Leczenia Chorob Pluc I Gruzlic, Otwock, Poland; Koranyi National Institute for Pulmonology, Budapest, Hungary; Hospital Universitario Central de Asturias, Oviedo, Spain; Centre Hospitalier Le Mans, Le Mans, France; F. Hoffmann-La Roche, Basel, Switzerland; CCR, National Cancer Institute, NIH, Bethesda, MD

Abstract:

Background: Erlotinib (E), a small-molecule EGFR TKI, is proven to extend survival versus placebo (P) in 2nd/3rd-line advanced NSCLC. The phase III SATURN study (BO18192) was initiated to evaluate E as maintenance therapy after standard 1st-line platinum-based chemotherapy (CT) in advanced NSCLC. Methods: Patients with no evidence of disease progression after 4 cycles of CT were randomized to receive either E 150 mg/day or P until progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS) in all patients and the co-primary endpoint was PFS in EGFR immunohistochemistry-positive (IHC+) patients. Results: A total of 1,949 patients entered the CT phase, of whom 889 were randomized to E (n=438) or P (n=451). Median age was 60 years for both arms. Baseline characteristics for E and P arms (%): male/female: 73/27 and 75/25; adenocarcinoma + BAC/squamous-cell/other: 47/38/15 and 44/43/13; stage IIIB/IV: 26/74 and 24/76; Caucasian/Asian/other: 84/14/2 and 83/15/2; ECOG PS 0/1: 31/69 and 32/68; current/former/never smoker: 55/28/18 and 56/27/17. PFS (by investigator assessment; confirmed by independent review) was significantly prolonged with E versus P in all patients (HR 0.71 [95% CI 0.62-0.82]; p<.0001) and in EGFR IHC+ patients (HR 0.69 [95% CI 0.58-0.82]; p<.0001). Subgroup analyses will be reported. Response rate was 12% with E versus 5% with P. Disease control rate (complete response + partial response + stable disease >12 wks) was 40.8% with E versus 27.4% with P (p<.0001). OS data are not yet mature. E was well tolerated: the majority of treatment-related adverse events (AEs) were grade 1/2. AEs reported in ≥10% of all patients were rash (60% with E versus 9% with P) and diarrhea (20% with E versus 5% with P); again, most were grade 1/2. Only 2.3% of patients receiving E had a serious treatment-related AE and 2.8% withdrew due to a treatment-related AE. Conclusions: The SATURN study met its primary and co-primary endpoints with high statistical significance. Erlotinib in the 1st-line maintenance setting is well tolerated, and significantly improves disease control and delays progression versus placebo across patient subgroups.


Abstract Disclosures

Faculty and Discussant Disclosures

Annual Meeting Planning Committee Disclosures

2009 Annual Meeting Proceedings Part I Errata

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy and are designated with a caret symbol (^) here and in the print version.


  Associated Presentation(s):

    

1. SATURN: A double-blind, randomized, phase III study of maintenance erlotinib versus placebo following nonprogression with first-line platinum-based chemotherapy in patients with advanced NSCLC.

Meeting: 2009 ASCO Annual Meeting
Presenter: Federico Cappuzzo, MD
Session: Lung Cancer - Metastatic (Oral Presentation)


  Other Abstracts in this Sub-Category:

    

1. Maintenance pemetrexed (Pem) plus best supportive care (BSC) versus placebo (Plac) plus BSC: A randomized phase III study in advanced non-small cell lung cancer (NSCLC).

Meeting: 2009 ASCO Annual Meeting   Abstract No: CRA8000   First Author: C. P. Belani
Category: Lung Cancer--Metastatic Lung Cancer - Metastatic Lung Cancer

    

2. A randomized, double-blind, placebo-controlled, phase IIIb trial (ATLAS) comparing bevacizumab (B) therapy with or without erlotinib (E) after completion of chemotherapy with B for first-line treatment of locally advanced, recurrent, or metastatic non-small cell lung cancer (NSCLC).

Meeting: 2009 ASCO Annual Meeting   Abstract No: LBA8002   First Author: V. A. Miller
Category: Lung Cancer--Metastatic Lung Cancer - Metastatic Lung Cancer

    

3. Vandetanib plus docetaxel versus docetaxel as second-line treatment for patients with advanced non-small cell lung cancer (NSCLC): A randomized, double-blind phase III trial (ZODIAC).

Meeting: 2009 ASCO Annual Meeting   Abstract No: CRA8003   First Author: R. S. Herbst
Category: Lung Cancer--Metastatic Lung Cancer - Metastatic Lung Cancer

    

More...


  Abstracts by F. Cappuzzo:

    

1. Biomarker analyses from the phase III placebo-controlled SATURN study of maintenance erlotinib following first-line chemotherapy for advanced NSCLC.

Meeting: 2009 ASCO Annual Meeting   Abstract No: 8020   First Author: W. Brugger
Category: Lung Cancer--Metastatic Lung Cancer - Metastatic Lung Cancer

    

2. SATURN: A double-blind, randomized, phase III study of maintenance erlotinib versus placebo following nonprogression with first-line platinum-based chemotherapy in patients with advanced NSCLC.

Meeting: 2009 ASCO Annual Meeting   Abstract No: 8001   First Author: F. Cappuzzo
Category: Lung Cancer--Metastatic Lung Cancer - Metastatic Lung Cancer

    

3. Effect of co-amplification of MYC and EIF3H on response and survival in non-small cell lung cancer (NSCLC) treated with gefitinib

Meeting: 2008 Molecular Markers   Abstract No: 52   First Author: H. A. Drabkin
Category: All - EGFR Pathway as a Target

    

More...


  Presentations by F. Cappuzzo:

    

1. SATURN: A double-blind, randomized, phase III study of maintenance erlotinib versus placebo following nonprogression with first-line platinum-based chemotherapy in patients with advanced NSCLC.

Meeting: 2009 ASCO Annual Meeting
Presenter: Federico Cappuzzo, MD
Session: Lung Cancer - Metastatic (Oral Presentation)

    

2. Effect of increased MET gene copy number on survival of surgically resected non-small cell lung cancer (NSCLC) patients.

Meeting: 2008 ASCO Annual Meeting
Presenter: Federico Cappuzzo
Session: Tumor Biology and Human Genetics (General Poster Session)

    

3. Clinical and biological effects of gefitinib in EGFR FISH positive/phospho-akt positive or never smoker non-small cell lung cancer (NSCLC): Preliminary results of the ONCOBELL trial.

Meeting: 2006 ASCO Annual Meeting
Presenter: Federico Cappuzzo, MD
Session: Lung Cancer II (Oral Presentation)

    

More...


  Educational Book Manuscripts by F. Cappuzzo:

    

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