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A. Inoue
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OA23 - EGFR Targeted Therapies in Advanced NSCLC (ID 410)
- Event: WCLC 2016
- Type: Oral Session
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:O.T. Brustugun, S. Lu
- Coordinates: 12/07/2016, 14:20 - 15:50, Stolz 2
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OA23.06 - Overall Survival (OS) of EGFR Mutation Positive Non-Small Cell Lung Cancer Patients: Real-World Treatment Patterns of 1,660 Japanese Patients (ID 5915)
15:15 - 15:25 | Author(s): A. Inoue
- Abstract
- Presentation
Background:
Since the epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) was launched in Japan, the survival periods of advanced/recurrent EGFR mutation positive (EGFR m+) non-small cell lung cancer (NSCLC) patients have been getting longer. However, clinical factors which contributed to the extension of survival periods of these patients remain unclear. We investigated overall survival, prognostic factors and treatments patterns of EGFR m+ NSCLC patients in real-world clinical practice.
Methods:
This is a multi-center, observational, retrospective study. Histologically or cytologically diagnosed EGFR m+ NSCLC patients who were started first-line treatment from 1/1/2008 to 31/12/2012 were enrolled. The primary objective was the estimated OS. The secondary objectives were to determine prognostic factors, real-world treatment patterns.
Results:
1,660 EGFR m+ NSCLC patients were enrolled from 17 hospitals in Japan (median age 67.0 years, female 64.8%, 38.9% had smoking history, ECOG-performance status 0, 1, 2, 3, 4 were 39.5%, 41.1%, 7.1%, 4.9%, 0.7%, respectively, adenocarcinoma 95.2%, 50.1% exon 19 deletion, 66.7% at stage IV). Median estimated OS was 29.7 months. Cox regression analysis revealed age, smoking history, performance status, histological diagnosis, EGFR mutation type and clinical stage were independently associated with OS. Five year survival rate of stage IV patients was 13.8%. The median number of treatment regimens was two. EGFR-TKI and platinum-doublet chemotherapy were most frequently used as first- and second-line treatments.
Conclusion:
Real world treatment of the large data-set of 1,660 EGFR m+ NSCLC patients was retrospectively investigated. Median OS was 29.7 months and EGFR-TKIs are major components of the treatment regimens for these patients in Japan. (NCT0247520)
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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-022 - QOL and Febrile Neutropenia: Japanese Phase 2 Trial of Docetaxel with/out Antiangiogenic Agent in 2nd Line NSCLC (ID 4035)
14:30 - 14:30 | Author(s): A. Inoue
- Abstract
Background:
Febrile neutropenia (FN) is one of the serious complications associated with cancer chemotherapy and often leads to dose reduction and change of administration schedule which may affect treatment outcomes. This post hoc analysis explored the association between FN and patient reported outcomes (PRO).
Methods:
PROs were collected in the trial JVCG with Lung Cancer Symptom Scale (LCSS) and EQ-5D-3L. LCSS includes 6 symptom questions (loss of appetite, fatigue, cough, dyspnea, hemoptysis, pain) and 3 global QOL items (symptom distress, difficulties with daily activities, QOL) measured on a 0-100 mm scale, with higher scores representing greater symptom burden. PROs were collected at baseline (BL, during 14days till randomization), around Day 21 in every cycle, at the timing of discontinuation and at 30-day follow up (FU). LCSS total score, global QOL total score, each global QOL item score, EQ-5D utility index and VAS score were calculated. Time to deterioration (TtD) of the LCSS and EQ-5D defined as increase from BL by ≥15 mm for LCSS and ≥15% drop for EQ-5D, respectively, was analysed using the Kaplan-Meier method stratified by treatment-emergent FN status.
Results:
Of 192 patients randomized to receive ramucirumab+docetaxel or placebo+docetaxel, 80.0% were male, median age was 64.6 and 54.0% had performance status1 at BL. FN occurred in 26.0% (50/192). Patients compliance with LCSS and EQ-5D were approximately 97.4% and 97.9%, respectively. Patients without FN showed longer TtD than patients with FN in LCSS total score and EQ-5D VAS score. Hazard ratio (HR) (95% CI) for LCSS total score were 0.731 (0.469, 1.141), p=0.0945 (stratified) with censoring rate of 44.0% (with FN) and 54.9% (without FN). For EQ-5D VAS score, HR were 0.802 (0.537, 1.199), p=0.5956 with censoring rate of 32.0% (with FN) and 43.0% (without FN). No significant difference was found.
Conclusion:
Prevailing clinical opinion suggests that FN negatively impacts QOL. In trial JVCG, a tendency was shown that QOL of patients with FN deteriorates more rapidly than in patients without FN, consistent with current beliefs. Additional investigation is needed but prevention and management of FN may contribute to maintaining QOL.
