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K. Kaira
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P1.15 - SCLC/Neuroendocrine Tumors (ID 701)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.15-002 - A Retrospective Study of Amrubicin Monotherapy for the Treatment of Relapsed Small Cell Lung Cancer in Elderly Patients (ID 7330)
09:30 - 09:30 | Author(s): K. Kaira
- Abstract
Background:
Amrubicin is one of the most active chemotherapeutic agents for small-cell lung cancer (SCLC). Previous studies reported its effectiveness and severe hematological toxicity. However, the efficacy of amrubicin monotherapy in elderly patients with SCLC has not been described. The objective of this study was to investigate the feasibility of amrubicin monotherapy in elderly patients, and its efficacy for relapsed SCLC.
Method:
A retrospective cohort study design was used. We retrospectively evaluated the clinical effects and adverse events of amrubicin treatment in elderly (≥70 years) SCLC patients with relapsed SCLC at one of four Japanese institutions (Gunma Prefectural Cancer Center, Tochigi Prefectural Cancer Center, Ibaragi Central Hospital, and Fukushima Medical University).
Result:
Between November 2003 and September 2015, 86 patients (aged ≥70 years) received amrubicin monotherapy for relapsed SCLC at four institutions There were 42 cases of sensitive relapse (S) and 44 of refractory relapse (R). S cases with median age of 75 years (range, 70–85 years) and R cases with median age of 74 years (range, 70–84 years) were included in our analysis. The median number of treatment cycles was 3 (range 1–9), and the response rate was 33.7% (40.5% in the S and 27.2% in the R cases). Median progression-free survival time was 4.0 months in the S and 2.7 months in the R patients (p = 0.013). Median survival time from the start of amrubicin therapy was 7.6 months in the S and 5.5 months in the R cases (p = 0.26). The frequencies of grade ≥3 hematological toxicities were as follows: leukopenia, 60.4%; neutropenia, 74.4%; anemia, 11.6%; thrombocytopenia, 16.2%; and febrile neutropenia, 17.4%. Treatment-related death was observed in 1 patient.
Conclusion:
Although hematological toxicities, particularly neutropenia, were severe, amrubicin showed excellent anti-tumor activity, not only in the S, but also in the R cases, as shown in previous studies. Amrubicin could be a preferable standard treatment in elderly patients with relapsed SCLC. These results warrant further evaluation of amrubicin in elderly patients with relapsed SCLC by a prospective trial.
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-027 - Clinical Significance of Topoisomerase-II Expression in Patients with Non-Small Cell Lung Cancer Treated with Amrubicin (ID 8859)
09:00 - 09:00 | Author(s): K. Kaira
- Abstract
Background:
Amrubicin (AMR) is one of treatment options in patients with previously treated advanced non-small cell lung cancer (NSCLC). Although topoisomerase-I (Topo-I) and topoisomerase-II (Topo-II) are identified as a targeting molecular of AMR, it remains unclear about the relationship between the efficacy of AMR and the expression level of these markers.
Method:
Between April 2004 and May 2014, 56 patients with advanced NSCLC who had received AMR were retrospectively analyzed. Clinical data including histological type, response to treatment, and survival were collected from medical records. The expression level of Topo II within tumor cell were evaluated by immunohistochemical staining.
Result:
The majority of enrolled patients were men (66.1%) and median age was 69 years (range, 43-78 years). The tumor samples consist of adenocarcinoma (69.6%), squamous cell carcinoma (21.4%), poorly differentiated carcinoma (3.6%), pleomorphic carcinoma (1.8%) and unclassified NSCLC (3.6%) Twenty percent of tumors had EGFR mutations. Percentages of tumors overexpressing Topo-I and Topo-II were 57% and 30%, respectively. Median progression-free survival (PFS) and overall survival (OS) for all patients was 2.4 and 10.9 months, respectively. Patients with low Topo-II expression had significantly longer OS than those with high Topo-II expression (12.9 months vs. 7.0 months, p<0.05) whereas there was no significant association between Topo-II expression status and PFS. The number of AMR treatment cycles, poor performance status, advanced stage and elevated Topo-II expression were significantly associated with unfavorable OS (P<0.05). Meanwhile, Topo-I expression status was not significantly associated with PFS or OS in the patients with NSCLC.
Conclusion:
The present study suggests that the expression levels of Topo-II (but not Topo-I) are associated with in patients with NSCLC receiving AMR.
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P2.02 - Biology/Pathology (ID 616)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.02-026 - Impact of PD-L1 Expression on 18F-FDG-PET in Pulmonary Squamous Cell Carcinoma (ID 7903)
09:30 - 09:30 | Author(s): K. Kaira
- Abstract
Background:
2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with positron emission tomography (18F-FDG-PET) is clinically useful for the evaluation of cancer. The accumulation of 18F-FDG within tumor cells is implicated in the expression of glucose transporter 1 (GLUT1) and hypoxic inducible factor-1α (HIF-1α). Although anti-programmed death-1 (PD-1) antibody therapy is approved for non-small cell lung cancer (NSCLC), the predictive biomarkers remain unknown. It was recently reported that the expression of programmed death ligand 1 (PD-L1) was positively correlated with the expression of GLUT1 and HIF-1α. Based on these backgrounds, we investigated the relationship between the tumor immunity including PD-L1 expression and the degree of 18F-FDG uptake in surgically resected pulmonary squamous cell carcinoma (SQC).
Method:
One hundred and sixty-seven patients (153 men, 14 women) with SQC who underwent 18F-FDG PET were included in this study. Tumor sections were stained by immunohistochemistry for GLUT1, HIF-1α, PD-L1, CD4, CD8, and Foxp3. Relationships of clinicopathological and molecular biological features to the degree of FDG uptake and survival were analyzed.
Result:
The SUVmax of 18F-FDG was significantly correlated with the expression of PD-L1 (p=0.0224) and GLUT1 (p=0.0075). The PD-L1 expression was significantly correlated either with GLUT1 (p=0.0059), HIF-1α (p<0.0001) or CD8 (p=0.0006). Other pairs exhibiting significant correlation are as follows: GLUT1 and HIF-1α (p=0.0072), HIF1α and CD8 (p=0.0072), CD8 and Foxp3 (p<0.0001). Univariate analysis demonstrated that advanced stage (p=0.0027), elevated SUVmax (p=0.0233), and elevated PD-L1 expression (p=0.0157) were associated with unfavorable overall survival (OS). Multivariate analysis also revealed that advanced stage (p=0.0445), elevated SUVmax (p=0.0382), and elevated PD-L1 expression (p=0.0173) were independent prognostic factors predicting unfavorable OS.
Conclusion:
18F-FDG uptake was significantly correlated with the expression of PD-L1 and GLUT1 in SQC. 18F-FDG PET may reflect the immune response in the tumor microenvironment involved in the regulation of PD-L1 expression.
