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T. Takahashi
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MA15 - Immunotherapy Prediction (ID 400)
- Event: WCLC 2016
- Type: Mini Oral Session
- Track: Chemotherapy/Targeted Therapy/Immunotherapy
- Presentations: 1
- Moderators:O. Arrieta
- Coordinates: 12/07/2016, 14:20 - 15:50, Schubert 1
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MA15.09 - Response to the Treatment Immediately before Nivolumab Monotherapy May Predict Clinical Response to Nivolumab (ID 4400)
15:20 - 15:26 | Author(s): T. Takahashi
- Abstract
Background:
Nivolumab was approved in Japan on December 17, 2015 for previously treated non-small cell lung cancer (NSCLC). The expression of programmed death-ligand 1 (PD-L1) in tumor tissue is considered a predictive factor for clinical response to nivolumab. However, in Japan, there are no commercially available diagnostic kits for evaluating PD-L1 expression. In addition, little is known regarding other predictive factors of response to nivolumab monotherapy in patients with NSCLC. Therefore, we examined the relationships between the response to nivolumab monotherapy and clinical parameters in patients with NSCLC.
Methods:
Between December 2015 and April 2016, we performed a retrospective analysis of 50 patients with NSCLC treated with nivolumab monotherapy (3 mg/kg, every 2 weeks) at our Institution in the clinical setting.
Results:
Baseline characteristics of patients who received nivolumab monotherapy were: median age, 65 years [range:39–76]; 60% male; 26% ECOG-PS 0, 64% ECOG-PS 1; 38% smoker; 58% stage Ⅳ disease, 22% postoperative recurrence; 80% non-squamous (SQ) NSCLC; 36% non-SQ NSCLC patients had active EGFR mutations; 20% second-line, 18% third-line. The objective response rate (ORR) for all patients treated with nivolumab monotherapy was 18% (95%CI 10–31). Univariate analysis revealed that predictive factors of response to nivolumab monotherapy were associated with “SQ”, “response to the treatment immediately before nivolumab monotherapy”, “therapeutic line of nivolumab (second-line and third-line treatment)” and “smoker” categories (Table 1). In the multivariate logistic regression analysis, the independent predictive factors were “SQ” (P = 0.0069) and “response to the treatment immediately before nivolumab monotherapy” (P < 0.0001) (Table 1). Figure 1
Conclusion:
“Response to the treatment immediately before nivolumab monotherapy”, other than “SQ” histology may be predictors of clinical response to nivolumab in patients with NSCLC.
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P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.08-075 - Salvage Surgery for Stage IV Non-Small Cell Lung Cancer (ID 3816)
14:30 - 14:30 | Author(s): T. Takahashi
- Abstract
Background:
There have been few reports regarding salvage surgery in patients with primary lung cancer, and the efficacy of salvage pulmonary resection for primary lung cancer have not been fully elucidated. Furthermore, salvage surgery for stage IV non-small cell lung cancer have been rarely performed. The purpose of this study is to evaluate the efficacy of salvage surgery for stage IV non-small cell lung cancer.
Methods:
We performed a retrospective analysis of 4 patients who underwent salvage pulmonary resection for stage IV non-small cell lung cancer between September, 2002 and September, 2015 at the Shizuoka Cancer Center Hospital.
Results:
Of 2606 cases of surgically resected lung cancer in our hospital, 4 cases (0.15%) of salvage surgery for stage IV non-small cell lung cancer patients were performed. There were 2 men and 2 women. The range of age was 38-63 years old (median 57 years old). The histological type was 3 adenocarcinomas and one large cell carcinoma. The reasons diagnosed stage IV non-small cell lung carcinoma were 2 liver metastasis, 1 brain metastasis, and 1 abdominal lymph node metastasis. All cases have administered chemotherapy, and salvage pulmonary resection was performed for persistent or recurrent primary lung tumors. The median period for surgery from chemotherapy was 17.5 months (range 13-55 months). The lobectomy was performed in all cases. There were no complications after surgery and the mean length of hospital stay was 9 days. Postoperative disease free survival of all patients was 2, 2, 5, 52 months (median 3.5 months), respectively. 3 cases had recurred after surgery and all of them were distant recurrence. 2 cases were died of disease (survival time 15, 42 months, respectively), 1 case was alive with recurrent disease, and 1 case was alive with no recurrent disease (survival time 52 months).
Conclusion:
Although almost all cases had developed distant recurrence after surgery early, one case was long-term survival. Salvage surgery might have been effective for highly selected stage IV non-small cell lung cancer patients.
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P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.02-031 - Survival Data of Postoperative Adjuvant Chemotherapy of Cisplatin plus Vinorelbine for Completely Resected NSCLC: A Retrospective Study (ID 5032)
14:30 - 14:30 | Author(s): T. Takahashi
- Abstract
Background:
Although the efficacy of postoperative adjuvant cisplatin (CDDP)-based chemotherapy, such as the combination of CDDP and vinorelbine (VNR) has been established for surgically resected non-small cell lung cancer (NSCLC), there has been some reports about the survival data of Asian patients treated with the combination of CDDP and VNR as adjuvant chemotherapy.
Methods:
We retrospectively have evaluated patient compliance and the safety of adjuvant chemotherapy with CDDP at 80 mg/m[2] administered on day 1 plus VNR at 25 mg/m[2] administered on days 1 and 8, every 3 weeks at the Shizuoka Cancer Center between February 2006 and October 2011 (Kenmotsu, et al. Respir Investig 2012). In this study, we evaluated survival data of these patients. Overall survival (OS) and relapse-free survival (RFS) after the start of adjuvant chemotherapy conducted by the Kaplan-Meier method to assess the time to death or relapse.
Results:
One hundred surgically resected NSCLC patients were included in this study. The characteristics of the patients were as follows: median age 63 years (range: 36–74); female 34%; never smokers 20 %; histology non-squamous/ squamous cell carcinoma 73%/ 27%; EGFR mutation mutant/ wild/ unknown 19%/23%/58%. Pathological stages IIA/IIB/IIIA were observed in 31/22/47%. The median time from surgical resection to the start of adjuvant chemotherapy was 44 days (range: 29–79 days). Median follow up was 5.6 years (range, 3.8 – 9.7 years). The five-year OS rate was 73% and the 2-year OS rate was 93%. The five-year RFS rate was 53% and the 2-year RFS rate was 62%. A univariate analysis of prognostic factors showed that patient characteristics (gender, histology, pathological stage) and dose intensity of cisplatin were not significantly associated with OS.
Conclusion:
Our results suggested that the prognosis of surgically resected NSCLC patients, who were treated with the combination of CDDP and VNR as adjuvant chemotherapy, might be better than previous results of adjuvant chemotherapies for NSCLC patients. This result can be influenced by the advances of diagnostic and surgical procedures, and the efficacy of chemotherapy including molecular target therapies.
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P2.05 - Poster Session with Presenters Present (ID 463)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.05-007 - Outcomes after Stereotactic Body Radiothrapy/Proton Beam Therapy or Wedge Resection for Stage I Non-Small-Cell Lung Cancer (ID 4409)
14:30 - 14:30 | Author(s): T. Takahashi
- Abstract
Background:
Recently, excellent results of stereotactic body radiotherapy (SBRT), proton beam therapy (PBT) for stage I non-small-cell lung cancer (NSCLC) have been reported, however any phase III trial comparing SBRT and surgery have not been completed yet. The aim of this study is to compare outcomes between SBRT, PBT and wedge resection (WR) for patients with peripheral stage I NSCLC who intolerable for anatomical resection, and analyze prognostic factors in this population.
Methods:
We retrospectively compared overall survival (OS), local recurrence rate (LRR), relapse-free survival (RFS) and cause-specific survival (CSS) between WR (n=172) and SBRT / PBT (n=188) for pathologically proven clinical stage I NSCLC in our institute from 2002 to 2015. Patients underwent WR were all high risk patients who intolerable for anatomical resection and achieved complete resection without any adjuvant therapy. Of radiation group (RT: SBRT+PBT), 56% was medically inoperable, with 44% refusing surgery. SBRT; 60 Gy in 8 fractions, PBT; 60-80 GyE in 10-20 fractions was prescribed. Propensity score matching was used to adjust the confounding effects in estimating treatment hazard ratios. 59 WR patients and 59 radiotherapy (RT) patients (SBRT 27, PBT 32) were matched blinded to outcome (1:1 ratio). There are 70 men and 48 women, median age was 81, and median follow-up period was 39 months.
Results:
3, 5 - year overall survival (OS) of WR and RT was 84.5%, 70.8% vs 89.7%, 59.6% (p=0.802), respectively. 3-year LRR, RFS, CSS were 94.7% vs 95.9% (p=0.751), 87.5% vs 75.6% (p=0.151) and 91.2% vs 93.9% (p=0.875), respectively. Multivariate analysis of prognostic factors for OS demonstrated any factors including treatment modality were not significant.
Conclusion:
Our results suggest that the treatment outcome of SBRT / PBT was equivalent to that of WR, SBRT / PBT may be alternative treatment in stage I NSCLC high risk patients.
