Several attendees questioned the use of four rather than six cycles of induction therapy, suggesting that patients may have been undertreated. Dr. Paz-Ares said that even in trials that mandate six cycles, patients typically receive a median of four or five cycles at maximum, and that one additional cycle likely would not have impacted overall survival.
"The whole thing here is that we have very few drugs that are active in non–small cell lung cancer and we have to be able to squeeze most of the benefit from each of them, and this is why I’m really in favor of this maintenance kind of treatment," he added.
PARAMOUNT was supported by Eli Lilly. Dr. Paz-Ares reported a consultant/advisory role with, and honoraria from, Bayer, Lilly, Pfizer, and Roche. His coauthors include employees of Eli Lilly. Dr. Kalemkerian reported research funding from Lilly.