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Y. Miura
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P3.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 208)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.01-007 - Evaluation of Gefitinib Efficacy According to Body Surface Area, Body Weight, and Body Mass Index in Patients with NSCLC Harboring EGFR Mutations (ID 1681)
09:30 - 09:30 | Author(s): Y. Miura
- Abstract
Background:
Gefitinib is effective as first-line chemotherapy for advanced non-small cell lung cancer (NSCLC) patients harboring sensitive epidermal growth factor receptor (EGFR) mutations. Exon 19 deletions and the L858R point mutation are the most commonly encountered sensitive EGFR mutations in NSCLC, and have been shown to predict greater efficacy of gefitinib therapy. The objective of this study was to evaluate whether body surface area (BSA), body weight (BW), and body mass index (BMI) affect the efficacy of gefitinib in patients with NSCLC harboring sensitive EGFR mutations.
Methods:
We reviewed the medical charts of consecutive patients with advanced NSCLC harboring sensitive EGFR mutations who received gefitinib. The median values were used as the cutoffs to evaluate the impact of BSA and BW on the efficacy of gefitinib. BMI was categorized as underweight (BMI < 18.5 kg/m[2]), normal weight (BMI 18.5 to < 25 kg/m[2]), and overweight (BMI ≥ 25 kg/m[2]).
Results:
The median BSA and BW of the 138 NSCLC patients harboring sensitive EGFR mutations were 1.48 m[2] and 53 kg, respectively. The overall response rate, progression-free survival (PFS), and overall survival (OS) were 65.2%, 12.2 months, and 24.2 months, respectively. There were no significant differences in clinical outcomes between the high-BSA (BSA ≥ 1.43 m[2]) and low-BSA groups (BSA < 1.43 m[2]), with response rates of 68.5% and 72.0% (p = 0.92), median PFS of 12.2 and 11.5 months (p = 0.73), and median OS of 25.0 and 21.9 months, respectively (p = 0.28). Moreover, there were no significant differences in clinical outcomes between the high-BW (BW ≥ 53 kg) and low-BW groups (BW < 53 kg), with response rates of 63.3% and 67.1% (p = 0.72), median PFS of 12.2 and 10.8 months (p = 0.46), and median OS of 28.9 and 21.9 months, respectively (p = 0.22). For BMI, the median PFS and OS estimated among underweight, normal weight, and overweight patients were 10.6 and 19.2 months, 12.0 and 23.3 months, and 13.1 and 33.1 months, respectively. There were no statistically significant differences in PFS and OS among underweight, normal weight, and overweight patients (p = 0.52 and p = 0.30, respectively). Finally, to substantiate possible differences in the efficacy in patients who are young (<75 years) vs. elderly (≥ 75 years) and who have exon 19 deletions vs. L858R, we also evaluated these subgroups separately regarding BSA, BW, and BMI. However, there were no significant differences in the PFS and OS between these groups.
Conclusion:
The efficacy of gefitinib in patients with NSCLC harboring sensitive EGFR mutations does not differ according to their BSA, BW, and BMI.
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P3.01-012 - Efficacy of Chemotherapy after First-Line Gefitinib for EGFR-Mutant NSCLC Patients (ID 762)
09:30 - 09:30 | Author(s): Y. Miura
- Abstract
Background:
Gefitinib is an effective first-line chemotherapy for advanced non-small cell lung cancer (NSCLC) patients harboring sensitive EGFR mutations. However, whether second-line platinum combination chemotherapy after first-line gefitinib treatment shows similar effects to first-line platinum combination chemotherapy in these patients remains unclear. Therefore, we here aimed to investigate the efficacy of platinum combination chemotherapy after first-line gefitinib treatment in NSCLC patients harboring sensitive EGFR mutations.
Methods:
We retrospectively evaluated the clinical effects of second-line platinum combination chemotherapy after first-line gefitinib treatment in NSCLC patients harboring sensitive EGFR mutations (exon 19 deletion or exon 21 L858R mutation) at 5 institutions. All patients were initially treated with gefitinib (250 mg/day) followed by platinum combination chemotherapy as second-line chemotherapy.
Results:
Between January 2006 and December 2012, 42 patients (8 men, 34 women; median age, 63 years [range, 39–75 years]) were enrolled. The overall response rate, disease control rate, and median progression-free survival (PFS) were 26.2%, 61.9%, and 5.1 months, respectively, after the second-line treatment. The corresponding values for first-line gefitinib treatment were 69.0%, 95.2%, and 11.1 months, respectively. Moreover, second-line platinum combination chemotherapy with pemetrexed or bevacizumab-containing regimens was indpendently associated with improved PFS.
Conclusion:
Second-line platinum combination chemotherapy after first-line gefitinib treatment in NSCLC patients harboring sensitive EGFR mutations was effective and showed equivalent outcomes to first-line platinum combination chemotherapy. After failure of first-line gefitinib therapy, second-line platinum combination chemotherapy with pemetrexed or bevacizumab might result in improved PFS.
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P3.07 - Poster Session/ Small Cell Lung Cancer (ID 223)
- Event: WCLC 2015
- Type: Poster
- Track: Small Cell Lung Cancer
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.07-004 - Clinical Impact of Post-Progression Survival for Overall Survival in Patients with Sensitive Relapse of Small Cell Lung Cancer (ID 1021)
09:30 - 09:30 | Author(s): Y. Miura
- Abstract
Background:
The effect of second-line chemotherapy on overall survival (OS) might be confounded by subsequent therapies in patients with sensitive relapse of small cell lung cancer (SCLC). But there is no research in this viewpoint. Therefore, we aimed to determine the relationships between progression-free survival (PFS), post-progression survival (PPS) and OS after second-line chemotherapy in this population.
Methods:
Between January 1999 and November 2013, seventy-seven patients with sensitive relapse of SCLC who had received second-line chemotherapy following first-line platinum doublet chemotherapy were analyzed. We retrospectively collected individual data at Gunma Prefectural Cancer Center and National Hospital Organization Nishigunma National Hospital from medical records, and evaluated patient characteristics, treatment data, tumor shrinkage, PFS, PPS and OS.
Results:
The median follow-up time was 13.1 months (range 2.3-80.8 months). The response rate, the disease control rate, median PFS and median OS were 58.4%, 93.5%, 5.1 months and 13.7 months, respectively. The relationships of PFS, PPS and tumor shrinkage with OS were analyzed at the individual level. Spearman rank correlation analysis and linear regression analysis showed that PPS was strongly correlated with OS (r = 0.91, p < 0.01, R [2]= 0.96), PFS was moderately correlated with OS (r = 0.58, p < 0.01, R[2 ]= 0.28), and tumor shrinkage was weakly correlated with OS (r = 0.34, p < 0.01, R[2 ]= 0.12). Using multivariate Cox proportional hazards model with a stepwise regression procedure to explore prognostic factors for PPS, the number of regimens after progression beyond second-line chemotherapy and performance status (PS) at the beginning of third-line treatment were both significantly associated with PPS (p < 0.01).
Conclusion:
PPS has more impact for OS than PFS in patients with sensitive relapse of SCLC. Moreover, this study suggests that subsequent treatment and PS after disease progression following second-line chemotherapy may be important factors that influence OS.
