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N. Shinagawa



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    P2.10 - Poster Session 2 - Chemotherapy (ID 207)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.10-017 - Efficacy of Pemetrexed in advanced non-small cell lung cancer with asymptomatic brain metastases (ID 1118)

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

      • Abstract

      Background
      Conventionally, the role of chemotherapy in brain metastases (BM) from non-small cell lung cancer (NSCLC) remains limited. However, some cases in which brain metastases (BM) are responsive to Pemetrexed (PEM) have been recognized recently.

      Methods
      We conducted a retrospective analysis of 74 advanced NSCLC patients who had received PEM-containing regimens in our institution from January 2006 to May 2013.

      Results
      Twenty-seven patients had been diagnosed as having BM before starting chemotherapy of PEM-containing regimens. The patient characteristics were: male/female = 12/15; median age (range) = 63 (25-85) years; smoking status: ever/never = 13/14; performance status: 0/1/2 = 0/26/1; histology: adenocarcinoma/NSCLC-NOS = 26/1; EGFR mutation status: positive/negative/unknown = 12/12/3; prior EGFR-TKI therapy: yes/no = 13/14 ; response to prior EGFR-TKI: CR/PR/SD/PD = 1/8/3/1. Fourteen patients had received any local treatments for BM, consisting of 7 whole brain radiotherapy (WBRT), 6 stereotactic radiotherapy (SRT), 2 stereotactic radiosurgery (SRS) and 2 brain surgery. The PEM-containing regimens administered were; CDDP+PEM/CBDCA+PEM/PEM alone = 2/9/16. The lines of chemotherapy was; 1st/2nd/3rd/4th or later = 5/7/9/6. They received the chemotherapy for a median cycle of 3 cycles (range 1-15). The overall response rate (ORR) was 14.8% (4/27) in total and the cranial response rate regarding BM was 14.8%(4/27), consisting of 1 CR and 3 PR. Of 13 patients who received prior EGFR-TKI, the cranial response rate was 23.1% (3/13). Of 17 patients without any prior local treatments for BM or with disease progression of BM after the prior local treatment, the cranial response rate was 23.5% (4/17).

      Conclusion
      The PEM-containing regimens might be a promising therapy for asymptomatic BM in NSCLC including those who showed resistance to EGFR-TKI.