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J. Skřičková
Moderator of
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SH05 - WCLC 2016 Scientific Highlights - Chemotherapy, Targeted Therapy and Immunotherapy of Advanced NSCLC (ID 487)
- Event: WCLC 2016
- Type: Scientific Highlights
- Track: Advanced NSCLC
- Presentations: 3
- Moderators:J. Skřičková, M. Samarzija
- Coordinates: 12/07/2016, 07:30 - 08:30, Hall C1
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SH05.01 - Chemotherapy of Advanced NSCLC (ID 7129)
07:30 - 07:50 | Author(s): C.P. Belani
- Abstract
- Presentation
Abstract not provided
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SH05.02 - Targeted Therapy of Advanced NSCLC (ID 7130)
07:50 - 08:10 | Author(s): J. Spicer
- Abstract
- Presentation
Abstract not provided
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SH05.03 - Immunotherapy of Advanced NSCLC (ID 7131)
08:10 - 08:30 | Author(s): L. Crinò
- Abstract
- Presentation
Abstract not provided
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Author of
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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-026 - Pemetrexed (Alimta) in Maintenance Therapy of 194 Patients with Advanced Non-Small-Cell Lung Cancer (NSCLC) (ID 4206)
14:30 - 14:30 | Author(s): J. Skřičková
- Abstract
Background:
The effectiveness and safety of continuation maintenance therapy with pemetrexed versus the watch-and-wait approach was proved by a large randomised phase III trial (Paz-Ares et al., 2013). We focused on continuance maintenance therapy with pemetrexed (Alimta) in routine clinical practice in the Czech Republic.
Methods:
The primary objective of our analysis was to evaluate the overall survival, defined as the length of time from the start of maintenance therapy to the date of death. Data was summarised using the standard descriptive statistics, absolute and relative rates for categorial variables, averages for continuous variables, 95% confidence intervals, as well as median, minimum and maximum values. Kaplan-Meier survival curves were used to display the patient survival. All analyses and graphical outputs were performed in the SAS 9.4 Software.
Results:
The analysed cohort of NSCLC patients treated with pemetrexed maintenance therapy in the Czech Republic as on March 2016 involved 194 patients. The median age was 64,0 years; stage IV was the predominant clinical stage (84,5%), 52.6% of patients were men, and 47,4% women. Adenocarcinoma was in 190 patients. From a total of 194 patients, treatment response was assessed in 173 patients. Among the assessed patients one showed complete regression (CR), 34 of them (19.7%) showed partial regression (PR), stable disease (SD) was the most frequent response, reported in 95 patients (54,9%); progression occurred in 36 patients (20.8%). Adverse events led to the termination of treatment in only 6 (3.5%) patients. The median number of cycles of maintenance therapy in our study was 5.0 (1.0; 24.0), and the median duration of maintenance therapy was 13.0 weeks. In the registration trial, the median number of cycles was 4.0 (1.0; 44.0). Median overall survival (median OS), was 15.4 months (95% CI: (12,7-18.18).
Conclusion:
The continuation maintenance therapy with pemetrexed (Alimta) has been shown to be effective and well tolerated in the Czech population. Treatment had to be terminated only in 6 (3.5%) patients due to adverse events. In the registration trial involving 359 patients (Paz-Ares et al., 2013), the continuation maintenance therapy with pemetrexed led to the median OS of 13.9 months, whereas in the Czech Republic, the median OS has been 15,4 months so far. However, a lower number of patients treated in the Czech Republic must be taken into account, and therefore this result is considered as preliminary.
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P3.02b - Poster Session with Presenters Present (ID 494)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02b-030 - Single Institution Experience with EGFR Gene Mutation Analysis and Treatment of EGFR Positive Patients in the Years 2010 to 2015 (ID 5022)
14:30 - 14:30 | Author(s): J. Skřičková
- Abstract
Background:
Our department is among several centers in the Czech Republic which comprehensively diagnose and treat patients with lung cancer, including mutational analysis of EGFR and subsequent personalised treatment.
Methods:
We present the results of mutational analysis of EGFR gene, and effects of treatment in patients with NSCLC with mutations in this gene who were in treatment in our department in the years 2010 to 2015. We processed the data to get a five year long, single institution experience.
Results:
In 786 examined patients, 65% were male. Average age of was 65.1 years, median 66 years. In these 786 patients, 1039 analyses of EGFR mutation status were done. 10% (79 patients) were EGFR positive. Within the group of EGFR-positive patients 65% were female. Average age was 65.6 years, median age 66 years. 62% (46 patients) with positive EGFR mutation were non-smokers, 33% (25 patients) former smokers and 5% (4 patients) smokers. 92% of patients had adenocarcinomas. The most frequent mutations were in exon 19 and 21. 65 % (51 patients) of the EGFR positive group were treated with TKI, in some of the lines of treatment. TKI was mostly used in the first line of treatment. 35% (28 EGFR positive patients) were not treated with TKI because of PS 3 or 4 (11 patients), prior radical surgery (9 patients) or radical radiotherapy (1 patient). 7 patients left for other center. Median PFS in the group of 23 patients, who were treated with TKI in first line, was 8.0 months (average PFS 8.9 months). The average OS of 31 patients who were treated in the years 2010 to 2015, including lines with chemotherapy, was 18.3 months (median 17, the longest survival 56 and the shortest 2 months). At the beginning of April 2016, 20 patients were still in treatment. The longest survival in this group was 61 months. Three patients with mutation T790M, occurring simultaneously with deletion in exon 19 showed surprisingly good results. One patient was still alive at the beginning of April 2016, and OS of the remaining two patients was 43 and 56 months.
Conclusion:
The majority of EGFR positive patients were treated with TKI, mostly in the first line. The rest of the patients either did not need TKI therapy, or TKI was not indicated because of their overall poor condition. Our experience is similar to the results of larger multicenter studies.
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P3.02b-082 - Gefitinib in First-Line Treatment of Caucasian Patients with NSCLC and EGFR Mutations in Exons 19 or 21 (ID 4207)
14:30 - 14:30 | Author(s): J. Skřičková
- Abstract
Background:
This study evaluates treatment outcomes in 182 NSCLC of Caucasian patients from Czech Republic according to activated mutations located in exons 19 (Del19) and 21 (L858R).
Methods:
NSCLC patients with EGFR activated mutations were treated with gefitinib in first line between 02/2010 and 3/2016 in 10 institutions. Retrospective analyses were carried out to assess the effectiveness and safety of gefitinib treatment according to activated mutations located in exons 19 (Del 19) and 21 (L858R).
Results:
Out of 182 patients, 119 (80 female, 39 male) had EGFR mutations in exon 19, and 63 (43 female, 20 male) in exon 21. Median age was 66 years in group with mutations in exon 19 and 69 years in group with mutations in exon 21. There was no statistically significant difference in gender ( p=0.999) and in age (p=0.093). No statistically significant difference was observed in the representation in smoking (p=0.0999). There was statistically significant difference in adenocarcinoma proportion (p=0.034). In the group with Del 19 were 97.56% patients with adenocarcinoma and in the grpup with L858R 88.9%. Between these two groups, there was no statistically significant difference according to performance status (p=0.999); according clinical stages (p=0.999). There was no statistically significant difference according to disease control (CR+PR+SD) (p=0.524); no statistically significant difference according the response to the treatment (CR + PR) (p=0.864). Statistically significant difference in the overall survival (OS) of patients was not proved on the chosen significance level of α=0.05. P-value of the Log-rank test: p=0.452. In the group of patients with Del19, the median OS was 21,4 months (CI 95%: 18.77- 24.28), in the group with L858R the median OS was 16.3 months (CI 95%: 10.1- 21.8). Median OS in both groups together was 20.2 months (CI 95%: 16.9- 23.5). There was no statistically significant difference (p=0.142) in progression free survival (PFS); in the group of patients with Del 19 it was 11,7 months (CI 95%:10.0-13.5), and in the group with L858R it was 8,8 months (CI 95% 6.9-10.6). Median PFS in both groups together was 10,6 months (CI 95%: 8.9-12.3). SimiIar numbers of adverse effects were observed in either group (33.6% and 33.3%).
Conclusion:
In both groups of patients, the treatment with gefitinib was very safe. PFS and median OS were satisfactory without statistically significant differences between the two groups; however, a better trend was observed in the group of patients with mutations in exon 19.
