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S. Akamine



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

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.10-038 - A phase II trial of the combination of gemcitabine and carboplatin as adjuvant chemotherapy in patients with completely resected non-small cell lung cancer. (Kenbyo 0601) (ID 2185)

      09:30 - 09:30  |  Author(s): S. Akamine

      • Abstract

      Background
      Background: Adjuvant chemotherapy for resected non-small cell lung cancer (NSCLC) is recommended with survival benefit, however low compliance in recent clinical trials. Objectives: We conducted a phase II trial of gemcitabine(G) and carboplatin(C) regimen for patients with completely resected NSCLC and carboplatin is administrated on day 8 to reduce hematological toxicity especially thrombocytopenia.

      Methods
      Eligibility criteria included: PS(ECOG) 0-1, age≦75 years, p-stage IB-IIIA NSCLC is complexly resected (R0), adequate hematological liver renal and cardiac function. Regimen: G (1000mg/m2) d1 +8 and C (AUC 5, d8) q.3wks. Primary end point of this study is feasibility and secondary end points are toxicity, overall and disease-free survival.

      Results
      44 patients (20 male, 24 female) were included, median age 63 (40-71) years. Adenocarcinoma in 39, squamous cell ca. in 4, pleomorphic ca. in 1, and pathological stage IB in 25, IIA in 8, IIB in 5, and IIIA in 6 patients. Thirty-three patients (75%) completed the planned 4 cycles of GC therapy and 28 (64%) received the planned doses. Thirty-four percent of the patients had grade 3/4 neutropenia, 2 (6%) had thrombocytopenia, and the other 2 (6%) had anemia. Non-hematological adverse effects were infrequent and no treatment-related death was noted in this study.

      Conclusion
      Hematological toxicity, especially thrombocytopenia in this study is less than that in the standard administration of CG (C day1) regimen. We conclude that this regimen is feasible with sufficient compliance as adjuvant chemotherapy for completely resected stage IB-IIIA NSCLC patients.

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    P3.10 - Poster Session 3 - Chemotherapy (ID 210)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P3.10-011 - Which do patients prefer as a first-line therapy, EGFR-TKI or chemotherapy, if they have NSCLC harboring EGFR mutation? A Vignettes study (LOGIK0903). (ID 1106)

      09:30 - 09:30  |  Author(s): S. Akamine

      • Abstract

      Background
      Treatment decision-making is associated with potential decisional conflict of patients. Aim of this study was to determine the preferences of advanced NSCLC patients for EGFR-TKI or chemotherapy as first-line therapy if they were in the situation of having a lung cancer harboring EGFR mutation, and to investigate the variables considered important to that preference.

      Methods
      Three vignettes were designed to assess the patients’, the physicians’ or medical staff members’ preferences for treatment decision-making and the reasons classified into five category such as “evidence level”, “type of drug administration”, “therapeutic efficacy”, “adverse events”, and “influence to ordinary life” behind the decision. HADS, FACT-L and characteristics of participants including gender, age, and performance status (PS) are also investigated in this analysis.

      Results
      Total 377 individuals containing 100 patients, 100 physicians, and 177 medical staff members were analyzed in this study, and 322 participants (85.4%) preferred to EGFR-TKI than chemotherapy as a first-line therapy. Preference rate of EGFR-TKI in patients was statistically significantly lower than those in physicians and medical staffs, 73%, 88% and 91%, respectively. Among the reasons we investigated, “therapeutic efficacy” was the only marginal significant reason for preference in patients (odds ratio: 3.88, p=0.06). In addition to “therapeutic efficacy”, “type of drug administration” and “influence to ordinary life” was the significant reasons for their preference in physicians (odds ratio: 11.57, 22.57 and 20.5, respectively). In pre-planned analysis, we found the difference of value between the patients and the physicians in “influence to ordinary life”.

      Conclusion
      If the patients have an advanced lung cancer with EGFR mutation, they may prefer EGFR-TKI as a first-line therapy to chemotherapy as well as physicians and medical staff members. However the reasons of those preferences among them may be different. We should consider continuation of patients’ ordinary life when we discuss about treatment decision-making with patients.