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P. Zhao



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

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.11-017 - Icotinib in advanced lung adenocarcinoma patients pretreated with pemetrexed (ID 1604)

      09:30 - 09:30  |  Author(s): P. Zhao

      • Abstract

      Background
      In non-small cell lung cancer (NSCLC), the well-developed epidermal growth factor receptor (EGFR) is important therapeutic target. EGFR activating gene mutations have been proved strongly predictive of response to EGFR-tyrosine kinase inhibitors in NSCLC. However, both in daily clinical practice and clinical trials, patients with unknown EGFR gene status (UN-EGFR-GS) are very common. In this study, we assessed efficacy and tolerability of sequential treatment of first-line pemetrexed followed by icotinib in Chinese advanced lung adenocarcinoma with UN-EGFR-GS.

      Methods
      We retrospectively analyzed 15 patients with advanced lung adenocarcinoma, who were treated first-line chemotherapy with pemetrexed and sequential using icotinib. The clinical characteristics, toxicity and survival status were collected through reviewing medical records, electronic preserved data, interviewing with patients or their family members. The overall survival (OS) was defined as the time of starting pemetrexed treatment to death or lost to follow up. The clinical course of included patients and treatment were prospectively monitored.

      Results
      Totally, 15 patients with advanced lung adenocarcinoma were included, 9 females, 6 males. The median age is 57 years old (ranges: 40-73y). Of the 15 patients, 11 were non-smokers and 4 were smokers. All the patients at least received one cycle of pemetrexed chemotherapy, and then were administered with icotinib. Four cases were received pemetrexed combined with carboplatin, 8 combined with cisplatin, and 3 as single use. The mean cycles of pemetrexed given to patients were 3.8(1-6cycles). The response rate to pemetrexed was 20.0% (3/15), stable disease 33.3% (5/15), progressive disease 40% (6/15). The icotinib use of 4 patients was for the purpose of maintenance therapy, 11 for second line. The response rate to icotinib was 40% (6/15), stable disease 26.7% (4/15), progressive disease 33.3% (5/15). There was no grade 3-4 toxicities observed during icotinib treatment phase. The most common grade 1-2 toxicities were rashes (26.7%), diarrheas (30%), elevated aminotransferase (13.3%) and elevated BUN (6.7%). At the end of follow up, 8 patients were dead, 7 alive. The median OS was 22.6 months. Two patients were still on icotinib treatment.

      Conclusion
      The sequence of first-line pemetrexed-based chemotherapy followed by icotinib treatment is a promising option for advanced lung adenocarcinoma with UN-EGFR-GS in China. The sequence yielded promising results with acceptable toxicity. The role of the sequential model for advanced NSCLC patients with adenocarcinoma histology should be further investigated in studies with larger sample sizes.

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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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      P3.10-046 - Patients with advanced non-small cell lung cancer(NSCLC) received multi-line treatments had better efficacy (ID 2804)

      09:30 - 09:30  |  Author(s): P. Zhao

      • Abstract

      Background
      Efficacy of advanced non-small cell lung cancer treatment has been in platform. How to integrate the limited drugs and design the sequence of regimens is the key point in clinical practice.

      Methods
      Clinical data of 215 patients of pathologically confirmed advanced non-small cell lung cell from January 2010 to December 2012 was analyzed retrospectively. The clinical features, pathological diagnosis, numbers of treatment lines and the efficacy were analyzed. Efficacy and adverse events were evaluated according to the RECIST 1.1 Criteria, NCI Common Terminology Criteria v3.0, respectively.

      Results
      Among 215 patients treated in our cancer center, 135 were men and 84 were women. The squamous cell carcinoma and adenocarcinoma was 50 and 74 in man ; 8 and 70 in women, respectively. 111 cases had 1 line treatment, 53 had 2 lines, 31 had 3 lines, 10 had 4 lines and 9 had more than 4 lines. In all lines, patients with adenocarcinoma compared to the squamous cell carcinoma had more opportunities to receive more drugs(P<0.05). The therapy regimen was decided by the Chinese medical insurance. Combined with platinum, gemcitabine was 29.3% and Taxanes was 26.5%. Either of these two regimens was the preferred choice. Tyrosine kinase inhibitors(TKI) including those offered by clinical trail and pemetrexed which were paid at patients’ own expense were 14%, 22.8%, respectively. In patients received 1, 2 and multi-line therapy(more than 2 lines), the partial response rate was 14.4%, 3.8%, 0, respectively. The stable disease rate was 28.8%, 32.1%, 30%, respectively. OS of patients with multi-line therapy(more than 2 lines) was longer than those with 1 and 2 lines treatment but the data was not mature.

      Conclusion
      Patients with advanced non-small cell lung cancer had multi-line treatment had better disease control. Their regimens mainly covered the chemotherapy and TKIs. Limited of the Chinese medical insurance, the first choice was gemcitabine/taxanes combined with platinum. Tailored therapy may explore the rational therapy sequence to get much better efficacy.