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J.D. Fikes
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P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.01-003 - T-Cytotoxic Specific Immunotherapy in NSCLC with Brain Metastases NCT00104780 (ID 1202)
09:30 - 09:30 | Author(s): J.D. Fikes
- Abstract
Background:
Brain metastases (BM) come with poor prognosis (median survival 3 to 6 months) and data are lacking as patients are often excluded from clinical trials.
Methods:
We present the results of a subgroup of NSCLC patients with BM treated with OSE-2101 (T-cytotoxic specific immunotherapy combining 9 epitopes targeting 5 tumor associated antigens and 1 pan-DR epitope) during a phase IIb study of OSE-2101 (1 injection per 3 week for 6 injections followed by 1 injection every 2 to 3 months) in advanced stage IIIB and IV NSCLC (Barve et al. 2008. J Clin Oncol 26:4418-4425). Patients were eligible whatever the number of prior chemotherapy (chemo) lines (65.5% entering 3rd line) and patients with stable BM for 2 months could be included. Six out of 64 treated patients had BM prior to inclusion and are reviewed.
Results:Table 1: NSCLC patients included with BM
AA: African-American, CAU: Caucasian, Chemo: chemotherapy, F: female, Gy: Gray, M: male, RT: radiotherapy, WBRT: whole brain radiotherapyPatient 108 150 169 132 133 135 Gender F M M M M M Ethnic origin CAU CAU CAU CAU AA CAU Age (years) 46 61 58 79 46 57 ECOG performance status 1 1 1 1 1 1 Previous treatment RT 30 Gy Chemo 2 lines WBRT 30 Gy Chemo 2 lines RT 30 Gy Chemo 2 lines WBRT 30 Gy Chemo 3 lines RT 30 Gy Chemo 1 line WBRT 30 Gy Chemo 3 lines Table 2: Response to therapy
* Patient still alive at the time of the last follow up, ** treatment stopped after 2 injections for progressive disease. CTL: cytotoxic T lymphocytes, HTL: helper T lymphocytes, mo: months, OS: Overall survival, The 6 BM patients present long survival (median 13 mo, range 7-41) considering the advanced stage and the poor prognosis of these heavily pretreated patients. All patients had received from 1 to 3 previous chemo lines. Evaluation of CTL responses to 5 epitopes of OSE-2101 in 5 patients shows that each patient had a CTL response to at least one and up to 5 epitopes. Surprisingly patients with positive HTL response (patient 108, 150, 169) achieve the longest OS when compared with negative HTL patients (132 and 133).Patient 108 150 169 132 133 135 OS 30.16 mo 41 mo* 16.5 mo 9.6 mo 11 mo 7 mo** Time without progression 11.57 mo 24.39 mo 11.9 mo 4.53 mo 6.2 mo 2 mo*[2] CTL response (positive epitopes out of 5 tested) 3 2 5 2 1 Not tested HTL response + + + - - Not tested
Conclusion:
Long OS has been documented in NSCLC patients with BM treated with T-specific immunotherapy following RT and 1 to 3 previous chemo lines.