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M. Ratknic
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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-071 - First-Line Gefitinib for EGFR-Mutated Lung Adenocarcinoma Patients with Bone Metastases - A Single Institution Experience (ID 5322)
14:30 - 14:30 | Author(s): M. Ratknic
- Abstract
Background:
Bone involvement has been considered as an adverse predictive factor in the systemic treatment of majority of malignant tumors. New horizon, opened with targeted agents, especially in lung cancer, faced us with encouraging results of treatment in advanced cancer patient population. Gefitinib, first generation tyrosine kinase inhibitor (TKI), has been a standard first-line treatment for EGFR mutated lung adenocarcinoma patients in Serbia since 2011.
Methods:
Fifty-one consecutive patients (pts) with advanced lung adenocarcinoma and EGFR mutation were treated with 1[st] line gefitinib at IORS since 2011. Fourteen of them were with bone metastases (BM). We compared treatment outcome of BM group (n=14) with group of pts without BM (n=37) in terms of progression-free survival (PFS) and overall survival (OS)
Results:
In the group of 14 pts with BM F/M ratio was 9/6, median age 57 years (26-64), 5/14 were never smokers. Performance status (PS) 1 had 7 pts, PS2 4 pts and PS3 3 pts. Eight pts had deletion of exon 19, five pts mutation in exon 21, one patient had double mutation G719X/S7681. Bone only metastases had 4/14 pts, additional metastatic sites in 10 pts were as follows: lung in 3 pts, liver in 2 pts, pleura in 3 pts and pericardium in 2 pts. The best therapy response in pts with BM was as follows: partial response in 5 pts, stable disease in 7 pts, progressive disease in 2 pts. Median PFS in BM group was 10.91 months (5.87-15.94, CI 95%) and 5.78 months (3.41-8.15, CI 95%) in the group of 37 pts without BM (log rank p=0.47). Median OS in BM group was 21.95 months (17.68-26.71, CI 95%), 18.17 months (5.95-30.30, CI95%), in pts without BM (log rank p=0.26). Toxicity of gefitinib was as expected and mild: skin rash grade 1 and diarrhea grade 1 in 9 pts, elevated transaminases grade 1 in one patient and grade 2 in one patient.
Conclusion:
In this small set of TKI treated advanced lung adenocarcinoma patients in 1[st] line, somewhat counterintuitive results were achieved: better PFS and OS results for BM group may be attributable to mutations more susceptible to TKI activity (mostly exon 19), absence of brain metastases in this group, good PS in one half of pts. But, it seems that stigma about poor results of systemic treatment in pts with BM should be set aside, at least in case of advanced adenocarcinoma of the lung and TKI.
