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K. Yamaguchi



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    P1.01 - Advanced NSCLC (ID 757)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P1.01-064 - Efficacy and Tolerability of Nivolumab in Elderly Patients with Advanced Non-Small Cell Lung Cancer (ID 9899)

      09:30 - 09:30  |  Author(s): K. Yamaguchi

      • Abstract

      Background:
      Immune checkpoint inhibitors are a novel group of immunotherapeutic agents. Antibodies to programmed death-1 (PD-1), such as nivolumab, have shown promising clinical activity in patients with advanced non-small-cell lung cancer (NSCLC), but their efficacy and safety in elderly patients with advanced NSCLC are unclear, because available major clinical trials involved a small number of elderly patients.

      Method:
      A total of 34 patients received nivolumab for advanced NSCLC from February 2016 to June 2017 in our hospital. We retrospectively reviewed the clinical medical records of these patients. They were divided into two groups; patients aged > 70 and < 70 years. Overall response rates (ORR), progression-free survival (PFS), major adverse effects and discontinuation rate due to adverse effects were compared between in two groups.

      Result:
      All of them were included in this study (median age was 64 years). Almost all patients had been previously treated with cytotoxic chemotherapy. They included 10 patients in aged > 70 years and 24 patients in aged < 70 years. There was no significant difference in histological type, performance status (PS), smoking history, line of therapy, and laboratory data between the two groups. Comparison between patients aged > 70 years and aged < 70 years in advanced NSCLC shows no statistically significant difference in median PFS (140 vs. 128, HR: 0.96, 95 % CI, 0.37-2.46, p = 0.93), ORR (40 % vs. 32 %, p = 0.70). The treatment was discontinued in 40 % (4/10) and 13 % (3/24) owing to adverse effect; however, there was no significant difference in two groups, and there was no adverse effect death in both groups.

      Conclusion:
      Nivolumab is tolerable and effective treatment for elderly patients with advanced NSCLC.

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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
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      P2.03-016 - Clinical Utility of Liquid Biopsy for Detecting EGFR T790M Mutation Is Very Limited (ID 8370)

      09:30 - 09:30  |  Author(s): K. Yamaguchi

      • Abstract

      Background:
      Osimertinib, a third-generation EGFR tyrosine kinase inhibitor targeting EGFR T790M acquired resistance mutation, has demonstrated strong clinical activity. Therefore, we have to do a second biopsy to detect T790M when the tumor has progressed. On the other hand, liquid based assays are expected as minimally invasive methods for detecting resistance mutations. Recently, liquid-biopsy for detecting EGFR T790M mutation has been approved by the Japanese ministry of health, labor and welfare. The aim of this study is to assess the clinical utility of liquid biopsy for detecting EGFR T790M mutation.

      Method:
      Seventeen consecutive patients who underwent cobas® EGFR Mutation Test ver.2 for liquid biopsy from January to April 2017 were enrolled. Patient information and examination results were collected from electronic medical records and analyzed retrospectively. Concordance between liquid biopsy and tissue or cytological specimen was assessed in patients who underwent re-biopsy at the same time as liquid biopsy.

      Result:
      Median age: 70 (51-82); Women: 10 (58.8%); Never smoker: 12 (70.6%); Adenocarcinoma: 17 (100%); Stage IV: 16 (94.1%); Primary EGFR mutation: exon19 deletion = 11 (64.7%), exon21 L858R = 5 (29.4%), exon18+20 mutations = 1 (5.9%). Two patients (11.8%) were positive for T790M mutation in plasma. Tissue biopsy or cytology was done in 8 cases at the same time as liquid biopsy. Only one patient of four patients who were positive for T790M in tissue or pleural effusion was positive for T790M in plasma (sensitivity: 25%). One patient of two patients who were positive for T790M in plasma was negative for T790M in spinal fluid.

      Conclusion:
      There is no doubt that liquid biopsy is a minimally invasive and very convenient method. However, at least currently, liquid biopsy cannot replace tissue biopsy in clinical setting because of its sensitivity. In order to deliver the appropriate medication to the patient, it is necessary to selectively use well the tissue biopsy and liquid biopsy.