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N. Reguart



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    P1.11 - Poster Session 1 - NSCLC Novel Therapies (ID 208)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.11-040 - Treatment strategies after failure to reversible Tyrosine Kinase Inhibitors (rTKI) in EGFR mutant (mut) Non-Small Cell Lung Cancer (NSCLC) patients (p). A retrospective analysis of 59 Spanish Patients (ID 2853)

      09:30 - 09:30  |  Author(s): N. Reguart

      • Abstract

      Background
      Different therapeutic approaches have been used in the clinical setting in NSCLC p harbouring EGFR mutations progressing to rTKI, although the standard of care in this situation is still not well established.

      Methods
      A multinstitutional database from five different centers in Spain was review to identify EGFR mut p with acquired resistance to rTKI in order to evaluate the therapeutic strategies after rTKI failure and the effect on the post-progression survival (PPS) of these treatments.

      Results
      59 p with acquired resistance to rTKI were identified: 61% female; median (m) age 63 ±11 yrs; 96.6% Caucasian; del19 73.7%, never or light former smokers 98.3%; 93.2% adenocarcinomas; 59.4 % received TKI as first line therapy; 87% were initial stage IV. mPFS for the rTKI was 9,9 months (mo) and mOS was 32.8 mo for the entire population. P were treated with a median of 2 therapeutic strategies after the rTKI failure. 6 therapeutic strategies have been identified. As immediate approach, 31p were switched to chemotherapy (CT) with a mPPS of 5,6 mo. 10 p were switched to an irreversible TKI obtaining a mPPS of 4 mo. rTKI plus other drug was maintained in 12 p: rTKI plus CT in 9 p with a mPPS of 5,8 mo and rTKI plus other drug different to CT in 3 with a mPPS of 2 mo. Despite the progression, rTKI was maintained in 3 p, considered slow progressors obtaining a mPPS of 1,4 mo with an OS of 9mo. Furthermore, 3p with oligometastatic progressive disease local therapy was added to rTKI, obtaining mPPS of 1,4mo, but an OS of 17 mo. 4 p were treated sequentially with ≥5 strategies. These p attained a mOS of 45mo.

      Conclusion
      The combination of different strategies when treating EGFR mut p after rTKI failure may impact the survival especially when p are candidates to receive some of this treatments sequentially. These strategies may reflect different subsets of EGFR mut disease.

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    P1.19 - Poster Session 1 - Imaging (ID 179)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      P1.19-002 - An open-label, single arm trial to evaluate the predictive value of perfusion CT and early radiologic response to cisplatin (C) gemcitabine (G) and bevacizumab (B) in patients (pts) with advanced or metastatic non-squamous non-small cell lung cancer (nsNSCLC). (ID 723)

      09:30 - 09:30  |  Author(s): N. Reguart

      • Abstract

      Background
      Classically the evaluation of response in oncology has been based in comparing pre and post treatment tumour volume by means of studying changes in the diameter lesions. The introduction of new targeted drugs creates the need of a different evaluation of tumours and their response to treatment. Functional imaging techniques that are able to study in vivo physiological processes of tissues and tumours have lately acquired more importance. The dynamic techniques may be more appropriate for assessing response to antiangiogenic drug, such as B, whose mechanism of action appears to focus on the normalization of the tumor vasculature. Preliminary studies have demonstrated significant and very early changes in flow, blood volume and tumor perfusion with therapy. These techniques could be useful to select patients those that are going to respond to drugs with an early evaluation of response by means of functional imaging

      Methods
      IMPACT is an open-label, single arm phase II study to evaluate the predictive value and early radiologic response or perfusion CT in pts diagnosed with unresectable advanced, metastatic or recurrent nsNSCLC treated with C, G and B. Pts receive B (7.5 mg/kg IV on d1), C (80 mg/m2 on d1) and G (1250 mg/m2 on d1 and 8) up to 6 cycles of 21 d. Pts with no evidence of progression of disease continue to receive single-agent B 7.5 mg/Kg on d1 every 21 d until progression or unacceptable toxicity. Primary endpoint is to assess basal results and early tumour response (at day +7) in terms of blood flow (BF), blood volume (BV), time to enhancement peak (TTEP) and permeability (P) as compared to Objective Response Rate (ORR) in terms of RECIST at d42. Secondary objectives include to assess tumour response (at d42) in terms of BF, BV, TTEP and P as compared to ORR at d42, to assess basal results in terms BF, BV, TTEP and P as compared to PFS and OS, to assess tumour response (at d7 and d42) in terms of BF, BV, TTEP and P to PFS and OS, to describe the safety profile using NCI-CTC AE and efficacy in the subgroup of adenocarcinoma. Planned sample size is 20 pts.

      Results
      not applicable

      Conclusion
      not applicable