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Di Ma
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P2.03 - Chemotherapy/Targeted Therapy (ID 704)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.03-004 - Recurrent Response to Advanced NSCLC with Erlotinib Developing Central Nervous System Failure during Gefitinib or Icotinib Treatment (ID 7424)
09:30 - 09:30 | Presenting Author(s): Di Ma
- Abstract
Background:
Approximately one-third of non-small-cell lung cancer (NSCLC) patients harboring EGFR mutations develop central nervous system (CNS) metastases as the progressive pattern during EGFR-TKIs treatment. We design this study to evaluate the feasibility and efficacy of erlotinib as the subsequent therapy when intracranial tumor progression occurs during gefitinib or icotinib treatment.
Method:
The study reviewed the clinical data of patients with advanced NSCLC who received erlotinib treatment after CNS progression of gefitinib or icotinib in Cancer Hospital Chinese Academy of Medical Sciences from June 2012 to July 2016.
Result:
In 29 eligible patients, the objective response and disease control rates of erlotinib for intracranial lesions (ICLs) were 10.3% and 86.2%, and for extracranial lesions (ECLs) were 0% and 93.1%, respectively. The median progression-free survival (PFS) of patients treated with erlotinib was 6.28 months (HR 1.729, 95% CI 2.887–9.663) and the median overall survival (OS) was 11.73 months (HR 2.394, 95% CI 7.036–16.422). Synchronous ICLs and ECLs progression in initial EGFR-TKIs treatment (HR 2.467, 95% CI 1.029-5.915, P=0.043) was found to be an independent adverse prognostic factor for PFS of erlotinib. The patients who received ≥ 2 lines of treatment before erlotinib had a poorer PFS (HR 3.340, 95% CI 1.369-8.152, P=0.008) and OS (HR 2.563, 95% CI 1.025-6.412, P=0.044). The median intracranial progression-free survival (iPFS) for initial EGFR-TKIs was 14.22 months (range, 0.56-35.12 months) and showed no significant difference in PFS and OS of erlotinib re-treatment in subgroup analyses. As for safety profile, the most common adverse events of erlotinib were hematological (44.8%), gastrointestinal reaction (20.7%) and rash (37.9%) in grade 1/2.
Conclusion:
Erlotinib can be used when intracranial tumor progression occurs during gefitinib or icotinib treatment. The progressive pattern of initial EGFR-TKIs and multiple prior treatments may influence the survival of patients with erlotinib re-treatment. Prospective studies are needed to confirm these results.
