Study Published in The Lancet Showed Significant Survival Benefit for Patients Facing Deadly Form of Lung Cancer
21 September 2009 - 1:00PM
PR Newswire (US)
Study Evaluated Lilly's ALIMTA® (pemetrexed for injection) versus
Placebo as Maintenance Therapy in Advanced Non-Small Cell Lung
Cancer Patients INDIANAPOLIS, Sept. 21 /PRNewswire-FirstCall/ --
Data published today in The Lancet showed a survival benefit in
nonsquamous patients with advanced non-small cell lung cancer
(NSCLC) who received maintenance therapy with ALIMTA (pemetrexed
for injection) plus best supportive care as compared to placebo
plus best supportive care. This Phase III clinical trial supported
previous studies looking at the use of histology to tailor
treatment with ALIMTA for patients with advanced nonsquamous NSCLC.
Advanced nonsquamous NSCLC patients on the ALIMTA plus best
supportive care arm achieved more than five months increased median
overall survival compared to nonsquamous NSCLC patients who
received placebo plus best supportive care following initial
chemotherapy. The publication of The Lancet manuscript follows the
July 2009 U.S. Food and Drug Administration (FDA) approval of
ALIMTA as maintenance therapy for patients with locally advanced or
metastatic nonsquamous NSCLC, whose disease has not progressed
after four cycles of platinum-based first-line chemotherapy. ALIMTA
is not indicated for treatment in patients with squamous cell
NSCLC. The European Commission also granted a similar approval in
July 2009. NSCLC is defined as a group of histologies, that is,
tumor types differentiated by cellular structure. Nonsquamous
histology includes adenocarcinoma and large cell carcinoma - which
account for about 70 percent of all NSCLC diagnoses(1) - as well as
histologies classified as "other." About 30 percent of all NSCLC
cases are squamous.(2) Maintenance therapy is a relatively new
concept in NSCLC treatment, according to study lead author Chandra
P. Belani, M.D., Miriam Beckner distinguished professor of medicine
and deputy director of Penn State Cancer Institute at Penn State
Milton S. Hershey Medical Center in Hershey, Pa. "Previously, we
would treat patients with advanced non-small cell lung cancer with
four cycles of a platinum-based therapy, and then wait for a
recurrence before treating again," said Dr. Belani. "The results of
this study are provocative and introduce the concept of maintenance
therapy for patients with non-small cell lung cancer." "What makes
these findings more compelling is a survival advantage exceeding
five months with ALIMTA for patients with nonsquamous cell
histologies. The degree of patient benefit is substantial," added
Dr. Belani. "This study is very encouraging for our fight against
this deadly disease," added Richard Gaynor, M.D., Lilly's vice
president of cancer research and global oncology platform leader.
"First, it makes a case for maintenance therapy in advanced,
nonsquamous NSCLC. Secondly, it showcases the importance of
histology in tailoring a treatment to the nonsquamous NSCLC
patient." The Lancet manuscript of ALIMTA as a maintenance therapy
for advanced nonsquamous NSCLC summarized findings from a global,
multicenter, double-blind Phase III trial that was presented by Dr.
Belani in an oral presentation at the American Society of Clinical
Oncology (ASCO) annual meeting in Orlando, Fla. on May 31, 2009.(3)
The trial compared the efficacy of ALIMTA plus best supportive care
versus placebo plus best supportive care in 663 patients with stage
IIIB/IV NSCLC whose disease had not progressed after four cycles of
platinum-based induction chemotherapy. According to the results,
patients treated with ALIMTA demonstrated statistically superior
overall survival compared to those treated with placebo (13.4
months vs. 10.6 months). But when breaking down the data by
histology, researchers found nonsquamous patients on the ALIMTA arm
achieved 15.5 months median overall survival compared to 10.3
months for nonsquamous patients on the placebo arm. Patients with
squamous cell carcinoma who were treated with ALIMTA did not see an
improvement in overall survival as compared to placebo (9.9 vs.
10.8 months, respectively). Patients in the trial were treated with
ALIMTA (500 mg/m2 on day one of each 21-day cycle) or placebo. All
patients were supplemented with vitamin B12, folic acid and
dexamethasone. Drug-related grade 3/4 toxicities were higher for
those treated with ALIMTA vs. placebo (16% vs. 4%); specifically,
anemia (3% vs. 1%), neutropenia (3% vs. 0%), leucopenia (2% vs.
1%), fatigue (5% vs. 1%), anorexia (2% vs. 0%),
mucositis/stomatitis (1% vs. 0%), diarrhea (1% vs. 0%), infection
(2% vs. 0%), and neuropathy-sensory (1% vs. 0%). Increases in
adverse reactions (all grades) were observed with longer exposure.
Grade 3/4 toxicities did not increase significantly in patients who
received greater than or equal to six cycles and greater than or
equal to ten cycles of ALIMTA. ALIMTA is also approved for:
first-line treatment of advanced, nonsquamous NSCLC in combination
with a platinum-based chemotherapy; as a single agent in the
second-line setting for advanced, nonsquamous NSCLC patients with
recurrent disease; and in combination with cisplatin as a treatment
for patients with malignant pleural mesothelioma, whose disease is
unresectable or who are otherwise not candidates for curative
surgery. For full prescribing and safety information about ALIMTA,
visit http://www.alimta.com/. Notes to Editor About Non-Small Cell
Lung Cancer (NSCLC) Globally, lung cancer impacts more than 3
million people and is one of the most common cancers worldwide,
accounting for 1.2 million new cases annually.(4) About 85 - 90
percent of all lung cancers are NSCLC.(5)(6) About Lilly Oncology,
a Division of Eli Lilly and Company For more than four decades,
Lilly Oncology has been dedicated to delivering innovative
solutions that improve the care of people living with cancer.
Because no two cancer patients are alike, Lilly Oncology is
committed to developing novel treatment approaches. Our quest is to
develop a broad portfolio of tailored therapies that accelerate the
pace and progress of cancer care. To learn more about Lilly's
commitment to cancer, please visit http://www.lillyoncology.com/.
About Eli Lilly and Company Lilly, a leading innovation-driven
corporation, is developing a growing portfolio of pharmaceutical
products by applying the latest research from its own worldwide
laboratories and from collaborations with eminent scientific
organizations. Headquartered in Indianapolis, Ind., Lilly provides
answers - through medicines and information - for some of the
world's most urgent medical needs. P-LLY ALIMTA (pemetrexed for
injection), Lilly Important Safety Information for ALIMTA ALIMTA is
approved by the FDA in combination with cisplatin (another
chemotherapy drug) for the initial treatment of advanced
nonsquamous non-small cell lung cancer (NSCLC), a specific type of
NSCLC. ALIMTA is not indicated for patients who have a different
type of NSCLC called squamous cell. ALIMTA is approved by the FDA
for the treatment of patients with advanced non-squamous non-small
cell lung cancer (NSCLC), a specific type of NSCLC, to maintain the
effect of initial treatment with chemotherapy and whose disease has
not worsened. ALIMTA is not indicated for patients who have a
different type of NSCLC called squamous cell. ALIMTA is approved by
the FDA as a single agent (used alone) for the treatment of
patients with advanced nonsquamous non-small cell lung cancer
(NSCLC), a specific type of NSCLC, after prior chemotherapy. ALIMTA
is not indicated for patients who have a different type of NSCLC
called squamous cell. ALIMTA is a treatment for malignant pleural
mesothelioma (MPM), which is a cancer that affects the inside
lining of the chest cavity. ALIMTA is given with cisplatin, another
anticancer medicine (chemotherapy), when surgery is not an option.
ALIMTA may not be appropriate for some patients. If you are
allergic to ALIMTA, tell your doctor because you should not receive
it. If you think you are pregnant, are planning to become pregnant,
or are nursing, please tell your healthcare team. ALIMTA may harm
your unborn or nursing baby. Your physician may advise you to use
effective contraception (birth control) to prevent pregnancy while
you are being treated with ALIMTA. If you have liver or kidney
problems, be sure to tell your doctor. Your dose of ALIMTA may have
to be changed, or ALIMTA may not be right for you. There is a risk
of side effects associated with ALIMTA therapy. ALIMTA can suppress
bone marrow function. It is very important to take folic acid and
vitamin B12 prior to and during your treatment with ALIMTA to lower
your chances of harmful side effects. Your healthcare professional
will prescribe a medicine called a corticosteroid, which lowers
your chances of getting skin reactions with ALIMTA. Ask your
healthcare professional before taking medicines called NSAIDs
(nonsteroidal anti-inflammatory drugs used to treat pain or
swelling). Tell your doctor if you are taking other medicines,
including prescription and non-prescription medicines, vitamins,
and herbal supplements. The most common side effects of ALIMTA when
given alone or in combination with cisplatin, another chemotherapy
drug, are low blood cell counts (red blood cells, white blood
cells, and platelets); tiredness; stomach upset, including nausea,
vomiting, and diarrhea; mouth, throat, or lip sores; loss of
appetite; rash; and constipation. Call your healthcare professional
right away if you have a fever, chills, diarrhea, or mouth sores.
These symptoms could mean you have an infection. These are not all
of the side effects of ALIMTA. If you have any side effect that
bothers you or that does not go away, be sure to talk with your
healthcare professional. You will have regular blood tests before
and during your treatment with ALIMTA. Your doctor may adjust your
dose of ALIMTA or delay your treatment based on the results of your
blood test and on your general condition. For more information
about all of the side effects of ALIMTA, please talk with your
healthcare team, see the Patient Prescribing Information and full
Prescribing Information, visit http://www.alimta.com/, or call
1-800-545-5979. You are encouraged to report negative side effects
of prescription drugs to the FDA. Visit
http://www.fda.gov/medwatch, or call 1-800-FDA-1088. This press
release contains forward-looking statements about the potential of
ALIMTA for the treatment of non-small cell lung cancer and reflects
Lilly's current beliefs. There is no guarantee that the product
will continue to be commercially successful. For further discussion
of these and other risks and uncertainties, see Lilly's filings
with the United States Securities and Exchange Commission. Lilly
undertakes no duty to update forward-looking statements. (Logo:
http://www.newscom.com/cgi-bin/prnh/20031219/LLYLOGO ) (1) The
Wellness Community, "Understanding Lung Cancer," Available at:
http://www.thewellnesscommunity.org/mm/Learn-About/cancertype/lungcancer/Under
tstanding-Lung-Cancer.aspx. Accessed July 24, 2009. (2) The
Wellness Community, "Understanding Lung Cancer," Available at:
http://www.thewellnesscommunity.org/mm/Learn-About/cancertype/lungcancer/Under
tstanding-Lung-Cancer.aspx. Accessed July 24, 2009. (3) C. P.
Belani, T. Brodowicz, et al. 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).
Abstract #CRA8000. 2009 American Society of Clinical Oncology
(ASCO) Annual Meeting. J Clin Oncol 27:18s, 2009 (suppl; abstr
CRA8000). (4) World Health Organization: Global cancer rates could
increase by 50% to 15 million by 2020, Fact sheet. Available at:
http://www.who.int/mediacentre/news/releases/2003/pr27/en/.
Accessed July 10, 2009. (5) American Cancer Society, "What Is
Non-Small Cell Lung Cancer?," October 15, 2007, American Cancer
Society,
http://www.cancer.org/docroot/CRI/content/CRI_2_4_1x_What_Is_Non-Small_Cell_Lu
ng_Cancer.asp?rnav=cri. Accessed February 21, 2008. (6) American
Cancer Society, "What Is Non-Small Cell Lung Cancer?," October 15,
2007, American Cancer Society,
http://www.cancer.org/docroot/CRI/content/CRI_2_4_1x_What_Is_Non-Small_Cell_Lu
ng_Cancer.asp?rnav=cri. Accessed February 21, 2008.
http://www.newscom.com/cgi-bin/prnh/20031219/LLYLOGODATASOURCE: Eli
Lilly and Company CONTACT: Amy Sousa, Lilly, +1-317-276-8478
(office), +1-317-997-1481 (mobile), ; or Neil Hochman, TogoRun,
+1-212-453-2067 (office), +1-516-784-9089 (mobile),
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