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J. Yang



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

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.10-024 - Clinical features of early interruption of EGFR-TKIs in unselected non small cell lung cancer patients (ID 2043)

      09:30 - 09:30  |  Author(s): J. Yang

      • Abstract

      Background
      Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is treatment of choice in non-small cell lung cancer patients with EGFR mutation, as well as has been recommended in the unselected patients in the 2nd or 3rd line treatment. However, many patients have no response from the EGFR-TKI treatment and there was often a lot of progress in early time of treatment.

      Methods
      The aim of this study was to analyze clinical features of patients who discontinued EGTF-TKI treatment within two months. We reviewed clinical characteristics of the patients, retrospectively.

      Results
      . Two hundred and fifty five patients received EGFR-TKIs from January 2010 to May 2013. Sixty nine patients (27%) discontinued within 2 months. The mean age was 64.4 years and smoking rate was 71%. The stages were IIIB 19 patients, IVa 14 (20.3%), and IVb 35 (50.7%), respectively. Forty four (63.8%) patients were adenocarcinoma, 19 (27.5%) squamous cell carcinoma, and 2 large cell carcinoma. In EGFR-TKI treatment, six patients (8.7%) in first line, 43 patients (62.2%) in second line, and 20 patients (30%) in third line or more were treated. Early discontinuation rate of gefitinib was 15.9% (22/138), elortinib 40.1% (47 / 117). EFGR mutation was positive in five patients who all have in exon 19 deletion. The mean duration of EGFR-TKIs was the average 25.5day. Tumor response was no change 42%, progressive disease 39.1%, and non-evaluable 18.9 %. After start of EGFR-TKIs, median survival time was only 68 days. The mean of mass diameter before treatment was 4.7cm, and increased to 5.9 cm when stop the drug. Survival time after EGFR-TKI treatment were significantly different based on ECOG PS (log-rank, p = 0.002), WBC> 10,000/uL (p = 0.007), albumin <3.0 g/dl (p = 0.001), and > LDH 500 IU/L (p = 0.036). Sixty five (94.2%) patients were stopped medication before routine response evaluation with CT scan. The reasons of drug discontinuation were disease progression in 24 (34.8%), serious side effect in 17 (24.6%), patient’s refusal in 3 (4.3%), doctor's decision in 22 (31.9%).

      Conclusion
      In conclusion, drop-out rate was higher in elortinib treated patients. Patients with poor PS, elevated WBC count, low albumin level, high LDH level have to be careful in the treatment with EGFR-TKI.