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T. Zhang
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JCES01 - Joint IASLC - Chinese Society for Clinical Oncology - Chinese Alliance Against Lung Cancer Session (ID 413)
- Event: WCLC 2016
- Type: Joint Chinese / English Session
- Track:
- Presentations: 1
- Moderators:F.R. Hirsch, C. Bai
- Coordinates: 12/04/2016, 08:00 - 11:45, Stolz 1
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JCES01.16 - A MET Inhibitor in the Treatment of Metastatic Non Small Cell Lung Cancer with MET Amplification (ID 7058)
11:10 - 11:10 | Author(s): T. Zhang
- Abstract
Background:
Amplification of the mesenchymal-epithelial transition factor (MET) gene plays a vital role in non-small cell lung cancer (NSCLC). The anti-MET therapeutic strategies are still unclear in epidermal growth factor receptor (EGFR) mutant patients and EGFR-naive patients. Aims of our study are to discuss role of MET amplification in Chinese NSCLC patients, and evaluate the antitumor activity of crizotinib (MET inhibitor) in Chinese NSCLC patients with MET gene amplification.
Methods:
From Jun 2015 to Jan 2016, we detected 11 metastatic NSCLC patients with MET amplification by fluorescence in situ hybridization (FISH). MET amplification was defined as gene focal amplification or high polysomy (at least 15% cells with ≥5 copy numbers). Patients with MET de novo amplification received crizotinib, patients with concomitant MET acquired amplification and EGFR mutation received combined therapy of EGFR-tyrosine kinase inhibitors (TKIs) (gefitinib, erlotinib, icotinib)and crizotinib. All enrolled subjects received tumor measurement according to RECIST1.1
Results:
The frequency of MET de novo amplification was 54.5%(6/11), and that of concomitant MET acquired amplification and EGFR mutation was 45.5%(5/11) respectively. 4 of 6 patients with MET de novo amplification received crizotinib, 2 patients had partial response (PR), 1 patient had stable disease (SD), 1 patient died due to heart disease. Response rate (RR) of crizotinib was 50%(2/4). Encouraging response was observed in one case, a CT scan performed 31 days after starting crizotinib revealed 42.2% decrease in tumor measurement, until now, a 7-month CT revealed 60.0% decrease. 3 of 5 patients with concomitant MET acquired amplification and EGFR mutation received the combined therapy of EGFR-TKIs and crizotinib. 1 patient achieved PR, 2 patients had SD. RR of combined therapy was 33.3%(1/3). Dramatic response was observed in one case with combined therapy, a 2-month CT revealed 31.0% decrease in tumor measurement.
Conclusion:
According to our study, patients with MET amplification benefited from crizotinib, and RR was inspiring. Patients with concomitant MET acquired amplification and EGFR mutation need combined targeted therapy.
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P2.03b - Poster Session with Presenters Present (ID 465)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03b-018 - Clinical Data from the Real World: Efficacy of Crizotinib in Chinese Patients with Advanced ALK+ Non-Small Cell Lung Cancer and Brain Metastases (ID 4091)
14:30 - 14:30 | Author(s): T. Zhang
- Abstract
Background:
Brain metastasis in NSCLC patients is often considered as a terminal stage of advanced disease. Crizotinib is a small-molecule tyrosine kinase inhibitor (TKI) for ALK-rearranged NSCLC patients that can improve systemic outcomes. Herein, a retrospective analysis of Crizotinib was performed in advanced ALK-rearranged NSCLC patients with brain metastases, to explore how Crizotinib affects the control of brain metastases and the overall prognosis in Chinese population in the real world.
Methods:
Advanced NSCLC patients with brain metastases who underwent Crizotinib treatment at the Cancer Hospital of the Chinese Academy of Medical Sciences between April 2013 and April 2015 were included. ALK translocation was determined by FISH, Ventana IHC test or RT-PCR. Brain metastases were diagnosed by CT or MRI.
Results:
A total of 34 patients were enrolled, of whom 20 patients had baseline brain metastases at the initiation of Crizotinib treatment. For patients with baseline metastases, overall survival (OS) after brain metastases was significantly longer, compared with those developing brain metastases during Crizotinib treatment (median OS, not reached vs. 10.3 months, p = 0.001). Among all the patients treated with chemotherapy at the first line, OS after brain metastases in patients with baseline brain metastases was significantly superior than those without (p = 0.023). Whereas, patients receiving Crizotinib at the first line with baseline brain metastases didn’t demonstrate such superior (p = 0.089). Among patients who developed brain metastases during Crizotinib treatment, for those receiving chemotherapy at the first line, though the result was not significant by the cut-off date, time to brain metastases was longer, compared with patients receiving Crizotinib at the first line (median time to brain metastases, 17.1 months vs. 10.5 months, p = 0.072).Figure 1
Conclusion:
Chinese ALK-rearranged NSCLC patients with baseline brain metastases may benefit more from Crizotinib than those developing brain metastases during Crizotinib treatment.
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P3.02c - Poster Session with Presenters Present (ID 472)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02c-008 - A MET Inhibitor in the Treatment of Metastatic Non Small Cell Lung Cancer with MET Amplification (ID 3908)
14:30 - 14:30 | Author(s): T. Zhang
- Abstract
Background:
Amplification of the mesenchymal-epithelial transition factor (MET) gene plays a vital role in non-small cell lung cancer (NSCLC). The anti-MET therapeutic strategies are still unclear in epidermal growth factor receptor (EGFR) mutant patients and EGFR-naive patients. Aims of our study are to discuss role of MET amplification in Chinese NSCLC patients, and evaluate the antitumor activity of crizotinib (MET inhibitor) in Chinese NSCLC patients with MET gene amplification.
Methods:
From Jun 2015 to Jan 2016, we detected 11 metastatic NSCLC patients with MET amplification by fluorescence in situ hybridization (FISH). MET amplification was defined as gene focal amplification or high polysomy (at least 15% cells with ≥5 copy numbers). Patients with MET de novo amplification received crizotinib, patients with concomitant MET acquired amplification and EGFR mutation received combined therapy of EGFR-tyrosine kinase inhibitors (TKIs) (gefitinib, erlotinib, icotinib)and crizotinib. All enrolled subjects received tumor measurement according to RECIST1.1
Results:
The frequency of MET de novo amplification was 54.5%(6/11), and that of concomitant MET acquired amplification and EGFR mutation was 45.5%(5/11) respectively. 4 of 6 patients with MET de novo amplification received crizotinib, 2 patients had partial response (PR), 1 patient had stable disease (SD), 1 patient died due to heart disease. Response rate (RR) of crizotinib was 50%(2/4). Encouraging response was observed in one case, a CT scan performed 31 days after starting crizotinib revealed 42.2% decrease in tumor measurement, until now, a 7-month CT revealed 60.0% decrease. 3 of 5 patients with concomitant MET acquired amplification and EGFR mutation received the combined therapy of EGFR-TKIs and crizotinib. 1 patient achieved PR, 2 patients had SD. RR of combined therapy was 33.3%(1/3). Dramatic response was observed in one case with combined therapy, a 2-month CT revealed 31.0% decrease in tumor measurement.
Conclusion:
According to our study, patients with MET amplification benefited from crizotinib, and RR was inspiring. Patients with concomitant MET acquired amplification and EGFR mutation need combined targeted therapy.
