Author of

• 10743

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

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 2
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10766

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    P1.10-023 - Favorable response to EGFR-TKI is a predictive marker of taxane activity, but not of pemetrexed in patients with non-squamous non-small cell lung cancer (ID 1412)

    09:30 - 09:30  |  Author(s): Y.I. Hwang
    • Abstract

    Background
    Both taxane and pemetrexed have significant activities as salvage chemotherapeutic agents in non-squamous non-small cell lung cancer (NSCLC). The purpose of this study was to compare the efficacy of taxane and pemetrexed according to EGFR activating mutation status in patients with advanced non-squamous NSCLC.

    Methods
    This retrospective analysis included patients with stage IIIA-IV non-squamous NSCLC given both taxane and pemetrexed in their clinical courses regardless of treatment line. Patients were dichotomized into favorable or unfavorable EGFR-tyrosine kinase inhibitor (TKI) response group. Favorable response group was defined as harboring EGFR activating mutation or partial remission and progression-free survival (PFS) ≥ 4 months with EGFR-TKI.

    Results
    62 patients were eligible for analysis (24 of favorable and 38 of unfavorable EGFR-TKI response group). Response rate (RR) of taxane based regimen was 37.5% vs. 28.9% (p=0.483) and disease control rate (DCR) was 79.2% vs. 55.3% (p=0.055) in favorable and unfavorable EGFR-TKI response group, respectively. RR of pemetrexed based regimen was 12.5% vs. 34.2% (p=0.057) and DCR was 66.7% vs. 76.8% (p=0.407) in favorable and unfavorable group, respectively. PFS with taxane based regimen was 5.5 months (95% CI 5.0-6.0) vs. 2.6 months (95% CI 1.4-3.8) in favorable and unfavorable group, respectively (p=0.006). PFS with pemetrexed based regimen was 4.1 months (95% CI 2.9-5.3) vs. 4.6 months (95% CI 1.9-7.2) in favorable and unfavorable group, respectively (p=0.361). PFS with taxane vs. pemetrexed based regimen was 5.5 vs. 4.1 months in favorable EGFR-TKI response group (p=0.027), and 2.6 vs. 4.6 months in unfavorable EGFR-TKI response group (p=0.112). The adjusted HR for disease progression of taxane based regimen in favorable EGFR-TKI response group compared with unfavorable group was 0.455 (95% CI 0.252-0.819; p=0.009) in multivariate Cox-regression analysis. However, PFS with pemetrexed based regimen was not associated with EGFR-TKI responsiveness (HR 1.014, 95% CI 0.547-0.877; p=0.966). The overall survival of favorable group vs. unfavorable EGFR-TKI response group was 45.4 vs. 22.8 months (p<0.001).

    Conclusion
    Favorable response to EGFR-TKI is a predictive marker of taxane activity, but not of pemetrexed in patients with non-squamous NSCLC. Taxane would be the first consideration for patients with disease progression after durable response to EGFR-TKI.

  • 10789

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    P1.10-046 - Heat shock protein 70 as a predictive maker in patients with platinum-based adjuvant chemotherapy in resected non-small cell lung cancer (ID 2735)

    09:30 - 09:30  |  Author(s): Y.I. Hwang
    • Abstract

    Background
    Although adjuvant platinum-based chemotherapy improves survival in completely resected non-small cell lung cancer (NSCLC), its effect is limited. We hypothesized that heat shock protein 70 (Hsp70) would be a biomarker for selecting patients for adjuvant chemotherapy, and evaluated the prognostic or predictive significance of Hsp70 in patients with surgically resected NSCLC.

    Methods
    Patients who underwent curative resection for NSCLC and diagnosed as stage IIA through IIIA between January 1996 and December 2010 were included. We conducted immunohistochemical staining for Hsp70 on surgical specimens and compared survival rates depending on whether of Hsp70 expression and adjuvant platinum-based chemotherapy.

    Results
    Among 327 patients, Hsp70 expression was positive in 220 (67.3%). For the patients without adjuvant chemotherapy, Hsp70 expression did not significantly affect survival. However, for the patients with adjuvant chemotherapy, patients with Hsp70-positive tumors had longer disease-free survival (DFS; 82.4 vs. 29.7 months; P = 0.004) as well as longer overall survival (OS; 101.9 vs. 73.4 months, P = 0.12) than those with Hsp70-negative tumors. Multivariate modeling showed that patients with Hsp70-postitive tumors had a lower risk of recurrence and death than those with Hsp70-negative tumors after adjusting for age, gender, performance status, pathologic stage, and histologic types in adjuvant chemotherapy group (DFS: adjusted hazard ratio [AHR], 0.54; 95% CI, 0.36 to 0.80; P = 0.002; OS: AHR, 0.66; 95% CI, 0.42 to 1.05; P = 0.08). Figure 1

    Conclusion
    Hsp70 is a positive predictive factor in completely resected NSCLC and Hsp70-positive tumors seem to benefit from adjuvant platinum-based chemotherapy.