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L. Yang
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-053 - Impact of Gender Difference on Adjuvant Chemotherapy after Radical Resection in Patients with Non-Small Cell Lung Cancer (ID 4081)
14:30 - 14:30 | Author(s): L. Yang
- Abstract
Background:
Gender was an important prognostic factor in patients with advanced non-small cell lung cancer (NSCLC). However, there are few studies reporting the impact of gender difference on the efficacy of adjuvant chemotherapy (ACT) in NSCLC patients.
Methods:
900 patients (584 men and 316 women) who received post-operative ACT in the Cancer Hospital of the Chinese Academy of Medical Sciences between 2001 and 2013 with complete records in the database of the hospital were analyzed in this study for analysis. The primary end point was disease-free survival (DFS) in terms of gender. Survival analysis was performed using Kaplan–Meier estimates, log-rank tests and Cox’s proportional hazards regression analysis. Propensity score matching (PSM) was used, and survival analysis of the match data were carried out.
Results:
There was no significant difference in DFS between the two groups in terms of gender before propensity score was matched (105.857 weeks [95%CI 86.699, 125.015] vs. 95.714 months [95%CI 81.905, 109.523], P=0.575). Furthermore, no significant impact of gender on DFS was observed between the PS-matched groups (102.429 weeks [95%CI 80.078, 124.779] vs. 99.143 weeks [95%CI 66.539, 131.746], P=0.893).
Conclusion:
The results suggest that gender was not a prognostic factor on ACT after radical resected NSCLC. However, these conclusions are limited by the nature of this retrospective study, and therefore prospective trials are required for further verification.
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P2.03a - Poster Session with Presenters Present (ID 464)
- 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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P2.03a-068 - Impact of Platinum/Pemetrexed versus Other Platinum-Based Regimens on Adjuvant Chemotherapy in Resected Adenocarcinoma Lung Cancer (ID 4590)
14:30 - 14:30 | Author(s): L. Yang
- Abstract
Background:
Adjuvant chemotherapy improves the survival for completely resected non-small cell lung cancer (NSCLC) patients. Platinum/pemetrexed is known to be less toxicity, better compliance and longer survival in advanced non-squamous NSCLC, but the survival outcome compared with other regimens in adjuvant setting is still unknown. This report described the survival in adjuvant chemotherapy for lung adenocarcinoma with platinum/pemetrexed versus other platinum-based doublets.
Methods:
389 completely radical surgery lung adenocarcinoma patients who received adjuvant chemotherapy with platinum/pemetrexed regimen (Group A, n=143) and non-pemetrexed platinum-based regimens (Group B, n=246) were analyzed retrospectively. Primary end point was disease-free survival (DFS). Propensity score matching (PSM) allowed best matched pairs for platinum/pemetrexed versus other platinum-based doublets for comparison of survival and adverse events.
Results:
PSM created treatment groups for platinum/pemetrexed versus non-pemetrexed regimen (125 pairs), docetaxel and paclitaxel (107 pairs), gemcitabine (56 pairs), and vinorelbine (24 pairs)-contained doublets, respectively. Although DFS was not significantly different between Group A and B (P=0.1643)(Figure A), in 125 PSM pairs, DFS was considerably better in patients who received platinum/pemetrexed regimen (P=0.0079)(Figure B). From the subgroup analysis, Pemetrexed benefit is consistent across different subgroups, and especially aging(>65) was associated with the decision to use platinum/pemetrexed (HR=0.25,95%CI 0.09-0.73, P=0,011). Furthermore, platinum/pemetrexed was associated with several significantly lower hematological and non-hematological AE rates, such as versus gemcitabine (Leukopenia: RR 0.514, p=0.001; Neutropenia: RR 0.688, p=0.002) and paclitaxel- and docetaxel-based chemotherapy (Leukopenia： RR 0.685, p=0.019; Neutropenia: RR 0.805, p=0.032).Figure 1
Conclusion:
Adjuvant chemotherapy with platinum/pemetrexed shows both better disease-free survival and less clinical toxicity than other non-pemetrexed based doublets in completely resected adenocarcinoma lung cancer.
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P3.02b - Poster Session with Presenters Present (ID 494)
- 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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P3.02b-085 - The Combination Therapy of S-1 and the Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors beyond Progressive Disease (ID 4078)
14:30 - 14:30 | Author(s): L. Yang
- Abstract
Background:
There is no optimal therapy established for those who have progressed with the Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI). And some preclinical study indicated that the addition of S-1 to EGFR-TKIs might overcome EGFR-TKI resistance. This study was conducted to investigate the efficacy and safety of the combination therapy of S-1 and EGFR-TKIs for patients failed the previous EGFR-TKI treatments.
Methods:
All patients who received the combination therapy of S-1 and EGFR-TKIs beyond progressive disease with EGFR-TKI monotherapy in the Cancer Hospital, the Chinese Academy of Medical Sciences between 2013 and 2016 with complete records were enrolled in this study. The primary endpoint was progression-free survival (PFS), while the disese control rate and safty were secondary endpoints. Multivariate analysis for survival was conducted including age, gender, initiation of EGFR-TKI, the choice of EGFR-TKI, the best efficacy while using EGFR monotherapy and the choice of S-1 and EGFR-TKI.
Results:
A total of 43 non-small-lung cancer (NSCLC) patients who met the inclusion criteria were enrolled in this study. The median PFS for all patients was 5.47 months (95% confidence interval [CI] 3.444-7.489). The disease control rate is 67.4%(29/43). There was no grade 4 toxicity and no grade 3 hematologic toxicity in this study. One patient has grade 3 elevated total serum bilirubin. Cox analysis showed that the combination treatment of S-1 and erlotinib was associated with decreased PFS comparing the gefitinib (hazards ratio[HR] 8.401, 95% CI 2.781-25.379, p<0.001). Besides, male (HR 0.389, 95%CI 0.162-0.934, p=0.035) and patients with SD (HR 0.303, 95%CI 0.124-0.471, p=0.009) or PD (HR 0.031, 95%CI 0.002-0.450, p=0.011) in the monotherapy of EGFR-TKIs were associated with increased PFS.
Conclusion:
The combination treatment of S-1 and EGFR-TKIs is effective and well-tolerated treatment for those failed prior EGFR-TKI. This strategy is promising to overcome EGFR-TKI resistance in NSCLC. A prospective study will be needed to confirm our studys.
