A Multicenter Randomized Phase Iii Trial Of Customized Chemotherapy Versus Standard Of Care For First-Line Treatment Of Elderly Patients With Advanced Non-Small Cell Lung Cancer (Epic)

TPS7619 Background: Personalizing therapy based on an individual patient’s molecular profile is a potentially promising approach to optimize efficacy with the available agents. Optimizing efficacy in the elderly is particularly relevant owing to their increased propensity to suffer therapy-induced toxicity. In this proposal we will attempt to demonstrate optimization of therapy in good performance EGFR mutation negative elderly patients by taking in to consideration the histology of the tumor, the ERCC1 (marker of platinum resistance), RRM1 (for gemcitabine resistance) and TS (for pemetrexed resistance) status. Methods: Untreated advanced stage NSCLC patients age u003e70 years with measurable disease will be enrolled. Patients will be randomized in a 2:1 randomization to experimental arm (A) or standard arm (B). In arm A, treatment with single or dual-agent chemotherapy will be selected based on histology, ERCC1 (E), RRM1(R) and TS (T) expression at the RNA level. The cut off for high (+, therefore resistant)...