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Xiaochun Zhang
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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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P2.03-034 - EGFR Exon 19 Deletion Is Associated with Favorable Overall Survival After First-Line Icotinib Therapy in Advanced NSCLC Patients (ID 9281)
09:30 - 09:30 | Presenting Author(s): Xiaochun Zhang
- Abstract
Background:
Although previous studies demonstrated that the PFS of geftinib, erlotinib and afatinib as first line treatment is superior to chemotherapy in advanced NSCLC patients harboring activating EGFR mutation, the efficacy of icotinib therapy as first line therapy has not yet been elucidated.
Method:
Patients with IIIB/IV NSCLC and a confirmed activating mutation of EGFR (exon 19 deletion or exon 21 L858R substitution) received oral icotinib (125 mg, three times per day) until disease progression or unacceptable toxic effects. The primary outcome was overall survival (OS), and the second endpoint were progression-free survival (PFS), objective response rate(ORR), disease control rate(DCR).
Result:
1615 patients with advanced NSCLC receiving icotinib from Oct. 2012 to Apr. 2016 were screened in four cancer centers in Qingdao city, P R.China, and 79 patients with intact follow-up data received icotinib in first-line setting and were enrolled.Of them, the number of women and men were 51 (64.56/%) and 28 (35.44/%) respectively. 27 (34.18%)patients were with EGFR exon 19 deletion, and 52(65.82%) patients with exon 21 L858R mutation. The median follow-up period at the time of analysis was 24.50 months. The objective response rate(ORR) was 45.57% (36/79) , and the disease control rate(DCR) reached 89.87%(71/79). One (1.27%) patient had CR, and 35(44.30%) patients had PR, 35(44.30%) patients had SD, 8(10.13%) patients with PD. The median PFS and OS were 13.61 months and 31.11 months respectively of overall population. The median PFS was 12.30 months in EGFR exon 19 mutation subgroup and 14.00 months in exon 21 mutation subgroup respectively(p=0.441). The exon 19 mutation group had a significantly longer median overall survival than exon 21 mutation group (34.72 months, vs. 28.66 months,log-rank p=0.006, hazard ratio, 0.31 95% CI, 0.13 to 0.71). Meanwhile, there is significant difference of overall survival during different ECOG PS subgroups(ECOG PS 0-1 versus ECOG PS 2-3,32.59 months versus 20.59 months,p=0.002,HR 3.09,95%CI, 1.46 to 6.52).
Conclusion:
The study illustrate that icotinib is effective as first-line treatment for patients with advanced NSCLC and sensitive EGFR mutation. The patients harboring EGFR exon 19 deletion mutation yield similar PFS, but longer OS compared to those harboring exon 21 L858R mutation.
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P3.03 - Chemotherapy/Targeted Therapy (ID 719)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 2
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.03-014 - Tumor Cavitation in Patients with Primary Lung Cancer Following Apatinib Treatment (ID 9054)
09:30 - 09:30 | Author(s): Xiaochun Zhang
- Abstract
Background:
Apatinib is a specific tyrosine kinase inhibitor that targets VEGFR-2. Treatment of primary lung cancer patients with apatinib is a new promising paradigm. In addition to hypertension and hand-foot syndrome, tumor cavitation and increase in CEA value are frequently noted in these patients. However, there are limited literatures regarding whether they could be used as potential biomarkers for anti-angiogenic therapy. This study was to evaluate the frequency and clinical outcome of primary lung cancer patients who developed tumor cavitation or showed increase in CEA value following apatinib treatment.
Method:
This was a retrospective analysis of primary lung cancer patients treated with apatinib in the Affiliated Hospital of Qiingdao University between 2/1/2015 and 5/19/2017. Clinical data were retrieved from medical records, and chest imaging findings were documented. Survival data were analyzed with Kaplan-Meier estimates and compared with log-rank test.
Result:
A total of 38 primary lung cancer patients received oral apatinib as the third-line or beyond therapy at an initial dose of 250 mg (n=37) or 500 mg (n=1) per day. During treatment, tumor cavitation was developed in 20 of the 38 (52.6%) patients. No significant difference was observed between patients with and without cavity formation in age, gender, tumor histology, tumor stage, history of pulmonary surgery and apatinib typical adverse events. Cavity formation was accompanied with temporary increase in CEA value (65.0% vs. 5.6% in patients with and without cavitary lesions; P=0.0001). The progression-free survival (PFS) of patients with cavitary lesions was 11.25 (95% CI, 10.16-13.64) months, which was significantly longer compared with those without (6.11 [95% CI, 6.01-6.71] months; P<0.0001). Besides, patients with a temporary increase in CEA had a longer PFS than those without (10.64 [95% CI, 10.09-14.14] vs. 6.14 [95% CI, 6.07-8.13] months), but the difference was not significant (P=0.0703).
Conclusion:
Cavitation formation induced by apatinib is common in primary lung cancer patients, and is not correlated with age, gender, tumor histology, tumor stage, history of pulmonary surgery and common adverse events. Cavitation might have significant effects on the temporary increase in CEA value and PFS prognosis.
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P3.03-018 - Tumor Cavitation in Lung Metastases in Patients with Solid Tumor Treated with Apatinib (ID 9694)
09:30 - 09:30 | Author(s): Xiaochun Zhang
- Abstract
Background:
Apatinib, a specific tyrosine kinase inhibitor targeting VEGFR-2, shows anti-angiogenesis effects in multiple solid tumors including lung cancer. Correlation between cavitation formation and outcome of some anti-angiogenic drugs is evaluated in patients with pulmonary cancer. However, the onset of cavitation in lung metastases in solid tumor patients following apatinib treatment has not been mentioned yet.
Method:
The clinical data of solid tumor patients with lung metastasis treated with apatinib in the Affiliated Hospital of Qiingdao University between 4/1/2015 and 6/17/2017 were collected from medical records, and chest imaging findings were documented. Survival data were analyzed with Kaplan-Meier estimates and compared with log-rank test.
Result:
Sixty-four eligible patients were identified (Table). The main primary tumor sites were stomach (n=23, 35.9%), colorectum (n=14, 21.9%) and liver (n=10, 15.6%). 93.8% patients received 250 mg/day of apatinib orally. Tumor cavitation formation in lung metastases occurred in 20 (31.3%) patients. None of these patients had preexisting cavity, which demonstrated that all cavitary lesions were developed during apatinib administration. There was no significant difference in age, gender, primary tumor site, histology and stage of lung metastases, history of pulmonary surgery and typical adverse events of apatinib between patients developed cavity or not. Compared with those without cavitary lesions, patients with cavitary showed higher rate of temporary increase in CEA (85.0% vs. 34.1%, P=0.0002) and longer progression-free survival (PFS; 15.44 [95% CI, 12.12-20.65] months vs. 6.71 [95% CI, 6.11-8.13] months, P<0.0001). However, patients with temporary increase in CEA showed longer but not significant PFS (11.15 [95% CI, 6.71-15.44] vs. 8.13 [95% CI, 6.31-15.57] months; P=0.3047).Table Baseline characteristics
Characteristics Cavitation (n=20) No Cavitation (n=44) Age, years mean±SD 58.65±10.35 61.27±13.86 Gender, n (%) Male 13 (65.0) 33 (75.0) Female 7 (35.0) 11 (25.0) Primary tumor site, n (%) Stomach 4 (20.0) 19 (43.2) Colorectum 5 (25.0) 9 (20.5) Liver 6 (30.0) 4 (9.1) Other 5 (25.0) 12 (27.3) Histology of lung metastases, n (%) Adenocarcinoma 16 (80.0) 38 (86.4) Squamous cell ca 2 (10.0) 2 (4.6) Other 2 (10.0) 4 (9.1) Stage of lung metastases, n (%) IIIA 0 (0.0) 2 (4.6) IIIB 3 (15.0) 13 (29.6) IVA 10 (50.0) 20 (45.5) IVB 7 (35.0) 9 (20.5) History of pulmonary surgery, n (%) 8 (40.0) 8 (18.2) Treatment lines, n (%) 2 4 (22.2) 5 (11.6) 3 12 (66.7) 33 (76.7) 4 1 (5.6) 2 (4.7) 5 1 (5.6) 3 (7.0)
Conclusion:
Cavitation development in lung metastases is accompanied with temporary elevation of CEA in patients treated with apatinib, and might be used as a potential biomarker for survival free of progression.
