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K. Sugio



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    P2.11 - Poster Session 2 - NSCLC Novel Therapies (ID 209)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.11-027 - The response of non-adenocarcinoma non-small-cell lung cancer patients with EGFR mutations to EGFR-TKI: A retrospective multicenter study (LOGIK 1104) (ID 2021)

      09:30 - 09:30  |  Author(s): K. Sugio

      • Abstract

      Background
      The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) such as gefitinib and erlotinib, are used to treat non-small cell lung cancer with EGFR sensitive mutations. The response rates to EGFR-TKI for mainly adenocarcinoma patients with EGFR mutations are very high, ranging from 62-85%, with a median progression-free survival (PFS) of 8.0-13.1 months and a median overall survival of 21.6-35.5 months. EGFR mutations can also be detected in a few non-adenocarcinoma tumors, however, the response of such cases to EGFR-TKIs is controversial. This study assessed the effectiveness of EGFR-TKIs in non-adenocarcinoma non-small cell lung cancer (non-adeno NSCLC) with EGFR mutations.

      Methods
      Nine institutions of the Lung Oncology Group in Kyushu (LOGIK) joined in this study. The primary endpoint was the response rate (RR), and the secondary endpoints were the disease control rate (DCR), overall survival, duration of disease control and the incidence of adverse events. A total of 43 cases of non-adeno NSCLC who were treated with EGFR-TKIs were retrospectively enrolled in this study.

      Results
      This study included 28 males and 15 females, and 18 of the 43 were never smokers. The ages of the patients ranged from 42 to 83 years, with a mean of 67 years. The pathological types were squamous cell carcinomas in 26 patients, adenosquamous cell carcinomas in six, large cell carcinomas in six, and others in five patients. Of these 43 cases, 18 with EGFR mutations were included in the analysis. The incidence of EGFR mutations was significantly higher in females than in males (80.0% vs. 21.4%, p<0.01), and in never smokers than in smokers (72.2% vs. 20.0%, p<0.01). The EGFR-TKIs administered were gefitinib in 27 patients and erlotinib in 16. In the patients with EGFR mutations, the RR and DCR were 83.8% and 93.8%, which were significantly superior to the rates in patients without EGFR mutations, which were 4.1% and 20.1%, respectively (p<0.01).

      Conclusion
      Even in patients with non-adeno NSCLC, the mutation of EGFR gene was a predictive factor for the response to EGFR-TKI treatment. In this meeting, we will show a detailed report based on the pathological analysis performed by the pathological committee of the LOGIK.

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    P2.12 - Poster Session 2 - NSCLC Early Stage (ID 205)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.12-012 - Prognostic impact of visceral pleural invasion in resected tumors of non-small cell lung cancer (ID 1622)

      09:30 - 09:30  |  Author(s): K. Sugio

      • Abstract

      Background
      A standardized definition of visceral pleural invasion (VPI) has been incorporated into the 7th edition of TNM, and the recommendations include the use of elastic stains to determine the VPI. PL0, defined as a lack of pleural invasion beyond the elastic layer, is not regarded as a T factor. In tumors of 3 cm or less, PL1 was defined as invasion beyond the elastic layer, and PL2 was defined as invasion to the surface of the visceral pleura, both of which are classified as indicators of T2 disease. The purpose of this retrospective study was to evaluate the validity of this definition.

      Methods
      We retrospectively reviewed 493 NSCLC patients with pathological N0M0 with a size of 5 cm or less with PL0-2 who underwent curative resection by lobectomy or segmentectomy between 1999 and 2013. We evaluated the disease-free survival (DFS) and overall survival (OS) in relation to the grade of VPI.

      Results
      The median follow-up for overall survival was 39 months after the operation. There were 282 males and 211 females included in the study. The age of the patients ranged from 31 to 90 years, with a mean of 69 years old. There were 347 patients in stage IA and 146 in Stage IB, and the histological type was adenocarcinoma in 374 patients (75.8%), squamous cell carcinoma in 91 patients (18.4%) and others in 28 patients (5.8%). The 5-year survival rates by PL grade were as follows: 85.0% for PL0 (n=425), 73.3% for PL1 (n=50) and 70.8% for PL2, respectively. In patients with tumors 3 cm or less in diameter, the 5-year survival rates and 5-year DFS rates were as follows: 87.9% and 88.2% for PL0 (n=342), 71.6% and 86.9% (n=30) for PL1 and 90.7% and 80.0% (n=11) for PL2, respectively. The 5-year survival rate of cases with PL0-T2a (> 3 cm, ≤ 5 cm) was 71.2%, and that for PL1-T2a was 71.6%, which did not differ significantly. Postoperative recurrence was observed in 47 patients (9.5%). Distant metastases were observed in 3.1% of PL0 patients, 10.0% of PL1 patients and 11.1% of PL2 patients, which showed significant difference between PL0 and PL1/2. However, no difference was found in the local recurrence rates between PL0 and PL1/2 patients.

      Conclusion
      The grade of VPI defined by the TNM 7th edition is reasonable. Namely, PL1 indicates visceral pleural invasion, and can be regarded as T2a disease.