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Z. Liu
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P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.01-065 - Bevacizumab Combined with Chemotherapy in the Treatment of Advanced NSCLC Patients (ID 386)
09:30 - 09:30 | Author(s): Z. Liu
- Abstract
Background:
Bevacizumab is a monoclonal antibody which selectively binds to human vascular endothelia growth factor（VEGF）.The combination of bevacizumab with chemotherapy has been one of the choices for advanced non-squamous non-small cell lung cancer（NSNSCLC） patients.In this study we evaluate the efficacy,safety and imaging findings of bevacizumab plus chemotheray in patients with advanced NSNSCLC.In addition, the mutation status of EGFR gene and KRAS gene were detected.
Methods:
Patients adimitted in the hospital were treated with bevacizumab (15mg/kg or 7.5mg/kg, d1) plus chemotherapy(paclitaxel 175mg/m2, d1, carboplatin AUC=5 or 6, d1) with 3 weeks in one cycle,up to 6 cycles,followed with maintenance therapy of bevacizumab(15mg/kg or 7.5 mg/kg, d1) till disease progression. Efficacy, safety, tumoral cavitation, therapeutic outcome of malignant pleural effusion and EGFR, KRAS mutation status were analysed.
Results:
Figure 1 Fig. Imaging changes of pleural effusion before and after treatment. A: Baseline CT of the chest showed plenty of pleural effusion on left side;B: Follow-up CT scan after 4 cycles of therapy demonstrated the pleural effusion had disappeared. 26 Patients were collected.They were all treated with bevacizumab plus chemotherapy.17 patients received maintenance therapy.The median cycle number of chemotherapy was 6, and that of bevacizumab was 8.Partial response(PR), stable disease(SD) and progressive disease(PD) rates were 53.8%, 42.3% and 3.8%，respectively. The median progression free survival(PFS) and overall survival(OS) were11.0 and 25.8 months respectively. Out of 26 patients, 15.4% developed cavitation after treatment.2 years and 3 years survivle rates of cavitation group were lightly higher than those of non-cavitation group(75.0% vs 44.4%, P=0.293, 25.0% vs 12.5%, P=0.509, respectively). Of the 13 patients with malignant pleural effusion, disease control rate of malignant pleural effusion was 100%: complete response(CR) rate was 38.5% and SD rate was 61.5%. EGFR gene ststus were detected in 11 patients. 36.4% showed sensitive mutation. The PR rate of EGFR mutation positive group was higher than that of mutation negitive group (75% vs 28.6%, P=0.262),but not statistically. KRAS mutation has not been found in all the 10 patients whose samsples were capable of being detected. Common adverse effects included myelosuppression, digestive symptoms,epistaxis, ect. Special adverse effects were also observed such as hemoptysis,hypertension,proteinuria etc. Most adverse effects were mild and controllable.
Conclusion:
Bevacizumab with chemotherapy is a promising and safe treatment for patients with NSNSCLC. It was also effective in controlling malignant pleural effusion. Tumoral cavitation were found, but the clinical significance was indeterminate. The relationship of EGFR gene status and efficacy of bevacizumab-based chemotheray is subject to further research.
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P3.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 208)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.01-050 - A Interim Analysis of Randomized Phase III Trial of Nedaplatin or Cisplatin Combined with Docetaxel as First-Line Treatment for Advanced ASQC (ID 1225)
09:30 - 09:30 | Author(s): Z. Liu
- Abstract
Background:
Cisplatin combined with docetaxel is one of the stand treatment in advanced squamous cell carcinoma(ASQC) of the lung. Nedaplatin combined with docetaxel has demonstrated potent activity in ASQC in phase II study. But until now there is no randomized phase III study comparing these 2 chemotherapy regimens. The aim of this study was to evaluate and compare the efficacy and safety between the combination chemotherapy of nedaplatin or cisplatin plus docetaxel in patients with ASQC.
Methods:
This is a multicentre, open-label, randomized, phase III study in China (NCT02088515). Chemo-naive stage IIIB/IV squamous NSCLC with Eastern Cooperative Oncology Group performance status 0/1 were randomized (1:1) to four cycles of nedaplatin (80 mg/m[2]) plus docetaxel(75 mg/m[2]) or cisplatin(75 mg/m[2]) plus docetaxel (75 mg/m[2]) . The primary endpoint was progression-free survival (PFS). Secondary end points were overall survival (OS), overall response rate (ORR), disease control rate (DCR) and quality of life.
Results:
From December 2013 to January 2015, 117 patients were accrued: nedaplatin plus docetaxel (n = 57) and cisplatin plus docetaxel (n = 60). The objective response rates were 27% and 31% and the disease control rate were 78.92 % and 82.67% in nedaplatin and cisplatin groups, respectively. There is no significance difference in nausea / vomiting(21% vs 30%) , diarrhea(3% vs 5%), liver dysfunction(12% vs 15%), neutropenia(60% vs 65%), thrombocytopenia(10% vs 12%), anemia(8% vs 7%) between the 2 arms. The renal dysfunction incidence is higher in the cisplatin group(3% vs 0%). Although there is no 3/4 grade toxicities difference between 2 arms including nausea / vomiting(0% vs 0%) , diarrhea(0% vs 1%), liver dysfunction(0% vs 0%), renal dysfunction(0% vs 0%) , neutropenia(4% vs 3%), thrombocytopenia(0% vs 0%), anemia(0% vs 0%) . This is an interim analysis and we haven't got the data of survival and quality of life.
Conclusion:
There is no ORR difference between the group of nedaplatin plus docetaxel and cisplatin plus docetaxel. But the toxicity of nedaplatin regiment is less toxicities, especially in renal toxicity,as first-line treatment for patients with advanced squamous NSCLC
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P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.02-008 - Clinical Characteristics of EML4-ALK Positive and Surgically Resected NSCLC Patients (ID 391)
09:30 - 09:30 | Author(s): Z. Liu
- Abstract
Background:
Along with the research progress of lung cancer-related driver genes, echinoderm microtubule-associated protein-like 4- anaplastic lymphoma kinas(EML4-ALK) positive non-small cell lung cancer(NSCLC), which is a distinctive molecular subtype, has been concerned. In this study we evaluate the clinical features of EML4-ALK positive and postoperative NSCLC patients.
Methods:
Clinical data of 42 patients with EML4-ALK positive, postsurgical NSCLC were retrospectively analyized. The organs of distant metastasis were observed. Log-rank test were used to analyse the relationship between clinical characteristics and disease free survival(DFS), overall survival(OS).
Results:
EML4-ALK positive patients are raletive young, most of them are never-smokers, peripheral type. The tumors were either moderately or poorly differentiated. The most common organ of distant metastasis was brain. Much more brain metastasis occurred in center type patients than in peripheral type patients(70.0% vs 30.0%，P=0.004).The median time from operation to brain metastasis was 17.2 months. The median post brain metastasis OS was 9.4 months. The DFS of earlier stage, peripheral type, moderately differentiated, without lymph node metastasis and with adjuvant treatment patients were significant longer than those of later stage(30.3months vs 12.8 months, P=0.016), center type(27.4months vs 7.3months, P=0.000), poorly differentiated(27.0 months vs 11.9months, P=0.048), with lymph node metastasis(30.0months vs 12.8months, P=0.027) and without adjuvant treatment(19.1months vs 1.8months, P=0.000) patients. Earlier stage, peripheral type, with adjuvant treatment patients obtained longer OS than later stage, center type, without adjuvant treatment counterparts（respectively 55.5months vs 26.2months，P=0.025; 39.2months vs 20.9 months， P=0.003; 33.4months vs 15.7months，P=0.001）. Tab 1 Clinical characteristics of paients
Tab 2 Relationship between clinical characteristics and DFS, OSCharacteristics No. of patients Percent(%) Gender Male 23 54.8 Female 19 45.2 Age(yr) ≤55 26 61.9 ＞55 Median(range) 16 52(23-71) 38.1 Smoking history Yes 13 31.0 No 29 69.0 Stage Ⅰ stage 10 23.8 Ⅱ stage 3 7.1 Ⅲ stage 24 57.1 Ⅳ stage 5 11.9 Tumor location Center type 12 28.6 Peripheral type 30 71.4 Histology Adenocarcinoma 39 92.9 Squamous cell carcinoma 0 0 Adenosquamous carcinoma 1 2.4 Others 2 4.8 Differentiation degree Well differentiated 0 0 Moderately differentiated 26 61.9 Poorly differentiated 16 38.1 Group DFS(month) P OS(month) P Gender Male 14.7 0.117 26.2 0.630 Female 18.8 32.8 Age(yr) ≤55 19.1 0.257 32.0 0.652 ＞55 17.4 30.0 Stage Ⅰ+Ⅱ stage 30.3 0.016 55.5 0.025 Ⅲ+Ⅳ stage 12.8 26.2 Tumor location Center type 7.3 0.000 20.9 0.003 Peripheral type 27.4 39.2 Smoking history Yes 7.0 0.167 22.9 0.524 No 17.4 32.8 Differentiation degree Moderately differentiated 27.0 0.048 39.2 0.055 Poorly differentiated 11.9 26.2 Tumor diameter >3cm 12.8 0.200 32.0 0.502 ≤3cm 27.0 33.4 Lymph node metastasis Yes 12.8 0.027 27.8 0.071 No 30.0 45.0 adjuvant treatment Yes 19.1 0.000 33.4 0.001 No 1.8 15.7
Conclusion:
EML4-ALK positive, postoperative NSCLC patients have distinctive clinical characteristics. The most common location of extrapulmonary metastasis was brain. DFS was associated with TNM stage, tumor location, differentiation degree, lymph node metastasis and adjuvant therapy. OS was related to TNM stage, tumor location and adjuvant therapy.
