Virtual Library

Start Your Search

D. Nakazato



Author of

  • +

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

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
    • +

      P2.11-009 - Erlotinib in metastatic pulmonary adenocarcinomas harbouring EGFR activating mutations, in Sao Paulo - Brazil. (ID 1025)

      09:30 - 09:30  |  Author(s): D. Nakazato

      • Abstract

      Background
      Background: EGFR-activating mutations are predictive of high response rates and overall survival gains in patients (pts) with pulmonary adenocarcinomas, treated with EGFR- tyrosine-kinase inhibitors (EGFR-TKIs), as erlotinib. Our objectives in this study were to analyze the efficacy and safety of erlotinib as first-line therapy or later in pts with adenocarcinomas harbouring EGFR-activating mutations.

      Methods
      Methods: It is a prospective, observational study on all consecutively pts whose tumors were genotyped for EGFR-activating mutations. All studied pts were treated in a single institution (ICESP) with erlotinib 150 mg PO daily. Tumor samples were formalin-fixed and paraffin-embedded. Tumor areas were selected and macrodissected, followed by whole DNA extraction and amplification by PCR. EGFR genotyping was performed through DNA sequencing (exons 18, 19, 20 and 21) by SangerĀ“s methodology.

      Results
      Results: 49 pts were treated with erlotinib from Nov/2010 to May/2013, as first-line (11 pts, 22%), second-line (31 pts, 63%) or third-line therapy (7 pts, 14%). Erlotinib was administered during a median time of 4 mo. (0.2-23.6 mo.). Among these 49 pts, 38 (78%) were diagnosed with adenocarcinomas harbouring EGFR-activating mutations: 26 with exon 19 deletions, 10 with L858R mutation in exon 21 and one presented a rare mutation in exon 18 (G719S). As expected, erlotinib was well tolerated, and acneiform rash and diarrhea were the most commonly observed toxicities. No treatment-related deaths were seen. Tumor response assessment was done in 42 pts: progressive disease was observed in 15 pts (36%) and 27 pts (64%) presented either partial response or disease stabilization. In a mean follow-up of 14 mo., 13 pts were dead. Median overall survival was not reached for the 38 pts with EGFR-mutated adenocarcinomas, and 1-year overall survival rate was 94% in these pts. In those pts with wild-type EGFR tumors, median overall survival was 15.6 mo (HR 0.17; 95% CI 0.02-0.33, p=0.0004). No difference in overall survival was observed between pts with EGFR-mutated adenocarcinomas if treated with erlotinib either as first-line therapy or later (HR 1.11; 95% CI 0.20-6.15, p=0.895). No difference in overall survival was observed between pts with EGFR-mutated adenocarcinomas according to the type of mutations (exon 19 deletions or others, p=0.147).

      Conclusion
      Conclusions: High rate of disease control (64%) and an impressive 1-year overall survival rate (94%) were observed among pts with metastatic pulmonary adenocarcinomas harbouring EGFR-activating mutations, as expected, with a favorable toxicity profile. These results do reinforce the importance of the correct identification of this subgroup of pts with EGFR-activating mutations and their treatment with an EGFR-TKI as a targeted therapy.