Author of

• 12592

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

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 2
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12597

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    P3.10-005 - A Phase II Study of Amrubicin and Carboplatin for Previously Untreated Patients with Extensive-Disease Small Cell Lung Cancer (ID 314)

    09:30 - 09:30  |  Author(s): M. Fukuda
    • Abstract

    Background
    Amrubicin and cisplatin are active in the treatment of small cell lung cancer (SCLC), and carboplatin is an analogue of cisplatin with less nonh ematological toxicity. To determine the efficacy and toxicity of amrubicin and carboplatin for previously untreated patients with extensive-disease (ED) SCLC.

    Methods
    Patients and methods: Thirty-five patients fulfilling the following eligibility criteria were enrolled: chemotherapy-naive, good performance status (PS 0-1), age < 76, extensive-disease, and adequate organ function. Based on the phase I study (J Thorac Oncol 4:741, 2009), the patients received amrubicin35mg/m[2] i.v. on days 1,2 and 3, and carboplatin AUC 5 i.v. on day 1. Four cycles of chemotherapy were repeated every 3 weeks.

    Results
    Results: Thirty-five patients we re eligible and 34 patients were assessable for response, toxicity and surviva l. Patients’ characteristics were as follows: male/female=27/8; PS 0/1=4/31; median age(range)=64(41-75); stage IV=35. The overall response was 81% (CR5, P R21, SD4, PD2, NE3). Grade 4 leukopenia, neutropenia, and thrombocytopenia occ urred in 11%, 60%, and 11%, respectively. There were no treatment-related deat h and pneumonitis. Three patients experienced hypotension for amrubicin infusi on reaction and two were terminated the study. The median overall survival tim e, and the 1-, 2- and 3-year survival rates were 15.6 months, 63%, 33% and 8%, respectively. The median progression-free survival time was 6.5 months.

    Conclusion
    Amrubicin and carboplatin was effective in untreated extensive-disease small cell lung cancer.

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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): M. Fukuda
    • 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.