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K. Nishino
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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: 2
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.01-014 - EGFR Tyrosine Kinase Inhibitor and Chemotherapy in EGFR Mutation-Positive Non-Small Cell Lung Cancer (ID 2378)
09:30 - 09:30 | Author(s): K. Nishino
- Abstract
Background:
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are recommended in the first-line setting for patients with EGFR mutation-positive non-small cell lung cancer (NSCLC). However, it remains unclear whether frontline EGFR TKIs are better strategy than first-line chemotherapy in EGFR-mutant patients. Generally, EGFR-TKIs had no significant benefits in overall survival (OS) compared with chemotherapy in both first-line and second-line setting. This retrospective study compared survival benefits in patients treated with post-TKI chemotherapy and first-line chemotherapy controls.
Methods:
This retrospective study included 442 EGFR-mutant patients in our institute. We examined EGFR gene status from 2007 to 2015. The patients treated from 1999 to 2015. The study group contained 173 patients treated with first-line EGFR-TKI and the control group contained 109 patients who received EGFR-TKI after first-line chemotherapy. The overall survival (OS) was assessed.
Results:
There was no significant difference between first-line chemotherapy and EGFR-TKI in OS for patients with mutation-positive NSCLC (median OS; 43 vs. 38 months, P = 1.645). There was substantial difference in OS between patients with postoperative recurrence and those with III/IV stage disease. Among patients with III/IV stage NSCLC, median OS was 40.8 months in first-line chemotherapy group, 30.5 months in chemotherapy after frontline EGFR-TKI group and 21.1 months in only EGFR-TKI group.
Conclusion:
In EGFR-mutant patients, both EGFR-TKI and chemotherapy improve the survival. Among patients with advanced NSCLC, EGFR-TKI after first-line chemotherapy may improve survival than frontline EGFR-TKI. These findings need to be validated in further randomized trials.
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P2.01-075 - Bevacizumab with Docetaxel or S-1 in Non-Squamous NSCLC (HANSHIN 0110) (ID 195)
09:30 - 09:30 | Author(s): K. Nishino
- Abstract
Background:
This multicenter, randomized phase II trial investigated the efficacy and safety of docetaxel plus bevacizumab and S-1 plus bevacizumab in the second-line treatment of non-squamous (non-Sq) non-small-cell lung cancer (NSCLC).
Methods:
Patients with non-Sq NSCLC who experienced disease progression after prior platinum-based chemotherapy with or without bevacizumab were randomly assigned (1:1) to receive docetaxel 60 mg/m[2] plus bevacizumab 15 mg/kg (DB) once every 3 weeks or S-1 40 mg/m[2] orally twice daily on days 1–14 plus bevacizumab 15 mg/kg (SB) on day 1 every 3 weeks until disease progression. The primary endpoint was progression-free survival (PFS).
Results:
Ninety patients were randomized. The median PFS was 3.9 months (95% confidence interval [CI] = 3.0–6.5) in the DB arm and 3.5 months (95% CI = 2.9–5.9) in the SB arm. The objective response rate was significantly higher in the DB arm than in the SB arm (22.2% vs. 2.2%; P = 0.004), whereas the disease control rates of the arms were identical (62.2% vs. 62.2%; P = 1.00). Patients receiving DB were more likely to have ≥grade 3 neutropenia (93.4% vs. 4.4%) and febrile neutropenia (33.3% vs. 0%) than SB-treated patients. In the DB arm, PFS and overall survival were significantly longer among bevacizumab-naïve patients than among bevacizumab-experienced patients (median PFS: 7.4 months vs. 2.8 months; P < 0.001; and median OS: 27.4 months vs. 11.7 months; P = 0.002).
Conclusion:
DB and SB produced modest PFS benefits in the second-line treatment of patients with advanced non-Sq NSCLC. Because of the toxicity of DB and the low response rate of SB, neither regimen warrants further investigation, excluding DB in bevacizumab-naïve patients with advanced non-Sq NSCLC.
