Author of

• 10743

  +

  P1.10 - Poster Session 1 - Chemotherapy (ID 204)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10780

    +

    P1.10-037 - A retrospective comparison of adjuvant chemotherapeutic regimen for non-small cell lung cancer (NSCLC): Paclitaxel plus platinum versus Vinorelbine plus Cisplatin (ID 2176)

    09:30 - 09:30  |  Author(s): S.H. Lim
    • Abstract

    Background
    Adjuvant vinorelbine/cisplatin (VC) has been demonstrated to increase overall survival in patients with AJCC 6th stage II/IIIA non-small cell lung cancer (NSCLC). Although adjuvant paclitaxel/carboplatin failed to demonstrate its efficacy in a study which enrolled only patients with AJCC 6th stage IB NSCLC, the exploratory analysis showed that patients with large tumor (≥ 4cm) got survival benefits from this regimen. We need to compare the clinical outcomes of these two regimens as adjuvant chemotherapy for NSCLC, since the previous prospective trials used different eligible stage criteria and AJCC stage system was recently updated.

    Methods
    We retrospectively analyzed patients with surgically completely resected NSCLC between December 2004 and December 2011. They received adjuvant chemotherapy using either paclitaxel/platinum (PP) or VC. Clinicopathological parameters, survivals including disease free survival (DFS) and overall survival (OS) and toxicity between two groups were compared. All tumor stages were updated based on the AJCC 7th edition.

    Results
    Of the 467 patients with surgically resected NSCLC, 236 received PP (paclitaxel/cisplatin, n=29; paclitaxel/carboplatin, n=206) and 231 patients got VC (n= 231). Two groups were well balanced with regard to demographics, histology, stage and type of surgery. Efficacy was comparable between two regimens: DFS (PP vs. VC: 65 vs. 55 months; p=0.42) and OS (73 vs 58 months; P=0.37). Regarding the adverse events, sensory neuropathy (41% vs. 11%), alopecia (19% vs. 4%), and myalgia (32% vs. 5%) are more frequent in the PP group, while anemia (71% vs. 87%), neutropenia (22% vs. 71%), fatigue (11% vs. 18%), anorexia (19% vs. 41%), and vomiting (9% vs. 19%) are more frequent in the VC group.

    Conclusion
    Although the adverse event profiles were different, the efficacy data in terms of DFS and OS were comparable between the two adjuvant regimens. Therefore, both regimens are appropriate as the adjuvant chemotherapy for NSCLC, and the selection can be done personally according to the expected profiles of adverse events.

• 11745

  +

  P2.11 - Poster Session 2 - NSCLC Novel Therapies (ID 209)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11775

    +

    P2.11-030 - Is there any predictor for clinical outcome in EGFR mutant<br /> NSCLC patients treated with EGFR TKIs ? (ID 2202)

    09:30 - 09:30  |  Author(s): S.H. Lim
    • Abstract

    Background
    Tyrosine kinase inhibitors (TKI) of the epidermal growth factor receptor (EGFR) have demonstrated dramatic response rate and prolonged progression-free survival (PFS) in advanced non-small cell lung cancer (NSCLC) patients with activating EGFR mutation. However, PFS and overall survival (OS) among those patients who were treated with EGFR TKIs are variable. In this study, we evaluated predictors of clinical outcome in EGFR mutant NSCLC patients treated with EGFR TKIs.

    Methods
    From January 2008 to December 2010, a total of 148 patients who had metastatic or recurrent NSCLC with activating EGFR mutation treated with either erlotinib or gefitinib as a first-line (n=10) and a second-line or more treatment (n=138) were retrospectively reviewed. The first analysis with a total 148 patients and subgroup analysis with patients who had received EGFR TKIs as second-line treatment (n=105) were undertaken to identify any difference in the clinical and molecular features among those patients who were treated with EGFR TKIs.

    Results
    Median follow-up duration was 21.9 months (range, 1.1-62.5) and median number of cycles was 7 (range, 1-44). The median PFS and OS for a total 148 patients were 10.6 months (95% CI, 9.0-12.2) and 21.8 months (95% CI, 18.5-25.1), respectively. The survival outcomes were similar between first-line and second-line or more line of treatment of EGFR TKIs (p=0.512 for PFS, p=0.699 for OS). A high number of metastasis sites (3-6 versus 1-2) was associated with shorter PFS and OS (median PFS 9.9 vs. 11.9 months, p=0.019; median OS 16.4 vs. 22.2 months, p=0.021, respectively) in univariate analysis, but not in multivariate analysis. According to the clinical and molecular markers by multivariate analysis, there were no significant differences in PFS. When PFS was dichotomized by median 11 months for 105 patients treated with EGFR TKIs as second-line therapy, no significant differences in any clinical or molecular features were found between longer PFS and shorter PFS groups.

    Conclusion
    Despite the heterogeneity in PFS among EGFR mutant patients treated with EGFR TKIs, no significant differences of clinical features were noted, suggesting more understanding of the variability of underlying biology should be needed.