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Bin-Chi Liao
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P2.07 - Immunology and Immunotherapy (ID 708)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Immunology and Immunotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.07-027 - Efficacy and Safety of Nivolumab Therapy for Advanced NSCLC in the Expanded Access Named Patient Program in Taiwan (ID 8711)
09:30 - 09:30 | Presenting Author(s): Bin-Chi Liao
- Abstract
Background:
Nivolumab is current standard of care for patients with pretreated advanced non-small cell lung cancer (NSCLC). The patients’ and physicians’ experience of using nivolumab in real-world clinical practice in Taiwan is unknown. We aimed to evaluate the efficacy and safety of nivolumab therapy in Taiwan.
Method:
We retrospectively reviewed the medical records of the patients with age > 20 years who were diagnosed to have advanced NSCLC and received nivolumab therapy through the Expanded Access Named Patient Program in 2016. Nivolumab 3 mg/kg was administered intravenously every 2 weeks.
Result:
A total of 94 patients were included in this analysis. The median age was 60 years (range, 31-76), and 63.8% of these patients were non-smoker. Most of the patients (75.5%) had adenocarcinoma histology, and 34.0% of the patients harbored an EGFR mutation. The median cycle number of nivolumab therapy was 9 (range, 1-28). The median treatment duration was 4.6 months (95% CI, 3.0-6.6). Nivolumab monotherapy is still ongoing in 16 patients (17.0%) on the date of data cutoff. The objective response rate was 13.8%. The median overall survival was 12.0 months (95% CI, 9.2 to not reached). In univariate analysis, sex, age, smoking history, EGFR mutation, squamous histology, and previous extracranial irradiation therapy were not predictors of prolonged survival. Only ECOG performance status (PS) < 2 before starting nivolumab therapy was a predictor of prolonged survival (HR: 0.32; 95% CI, 0.17-0.59). The most common treatment related adverse events (AEs) included fatigue (34.0%), nausea (17.0%), rash (12.8%), asthenia (8.5%), and pyrexia (5.3%). Grade ≧ 3 AEs developed in 7.4% of the patients. All grades interstitial lung disease developed in 4.3% of the patients. One patient died of grade 5 diarrhea after one dose of nivolumab therapy.
Conclusion:
The efficacy and safety data in Taiwan were in line with previous clinical trial reports. Patients with PS < 2 may have better survival outcome after receiving nivolumab therapy.
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P3.01 - Advanced NSCLC (ID 621)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.01-006 - Osimertinib in Pretreated EGFR T790M-Positive Non-Small Cell Lung Cancer Patients with Leptomeningeal Carcinomatosis (ID 7905)
09:30 - 09:30 | Presenting Author(s): Bin-Chi Liao
- Abstract
Background:
Leptomeningeal carcinomatosis (LC) is a detrimental complication of non-small cell lung cancer (NSCLC). Osimertinib is the current standard therapy for pretreated EGFR T790M-positive NSCLC patients. However, the efficacy of osimertinib for these patients with LC is unknown.
Method:
Retrospective case series of 5 patients with pretreated EGFR T790M-positive NSCLC who developed LC and received osimertinib therapy in an Expanded Access Program was reviewed. We evaluated the clinical outcomes of these patients.
Result:
Four female patients and one male patient (age, range 51-67) with EGFR T790M-positive NSCLC and LC received osimertinib therapy at a starting dose of 80 mg/day. EGFR T790M mutation was detected in three re-biopsied specimens and two plasma samples. Four patients had Eastern Cooperative Oncology Group performance status (PS) ≧ 2. One patient received whole-brain radiotherapy after commencing osimertinib therapy. Osimertinib dose escalation to 160 mg/day or 160 mg every other day was administered to 3 patients who did not respond to standard dose therapy. Radiologically decreased leptomeningeal enhancement was seen in 3 out of 4 evaluable patients, and improvement of clinical symptoms was recorded in 2 patients. Two patients died of aspiration pneumonia, and one died of hypoxic respiratory failure of unknown cause. Osimertinib therapy is ongoing in two patients at 80 mg/day for 9 and 10 months, respectively, with good tolerability.
Conclusion:
Osimertinib is well tolerated even in patients with poor PS. Clinical benefits were seen in some patients, and the optimal dose should be explored.
