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C. Lin
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MA 03 - Chemotherapy (ID 651)
- Event: WCLC 2017
- Type: Mini Oral
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:Jin-Hyoung Kang, W. Su
- Coordinates: 10/16/2017, 11:00 - 12:30, Room 502
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MA 03.07 - The Predictive Value of Interferon-γ Release Assays (IGRA) for Chemotherapy Response in Advanced Non-Small-Cell Lung Cancer Patients (ID 8059)
11:40 - 11:45 | Author(s): C. Lin
- Abstract
- Presentation
Background:
Background: INF-γ had recently been known to take part in cancer immunology and its interactions with chemotherapy were also described. Our previous study had showed that impaired PHA-stimulated INF-γ (PSIG) response from peripheral lymphocytes was associated with lower one-year overall survival in advanced non-small cell lung cancer (NSCLC) patients. In this study, we aimed to evaluate the correlation between PSIG and chemotherapy response.
Method:
Form January 2011 to August 2012, 340 newly-diagnosed lung cancer patients from 4 referral centers in Taiwan were enrolled in a prospective latent TB observational study. Patients who had advanced NSCLC and had been treated with chemotherapy were included in this study. The pretreatment PSIG levels were evaluated by Interferon-Gamma Release Assay (IGRA) with QuantiFERON-TB In-Tube (Qiagen, Germany). Patients were grouped into high PHA response group if their PSIG levels were above the median level; the others were grouped into low PHA response group. Their demographic characteristics, tumor response, and survival were investigated and correlated with PSIG levels.
Result:
Eighty-four patients were enrolled in this study. The response rate in high PHA response group was 45.2%, versus 35.7% in lower PHA response group (p=0.999190). The disease control rate in high PHA response group was 76.2%, versus 52.4% in low PHA response group (p=0. 023999). In multivariate analysis, PSIG response was an independent predictor for disease control rate (OR=3.017, 95% CI= 1.115-8.165). Also, the Kaplan-Meier curves and estimates survival analysis demonstrated both longer progression-free survival (p=0.008) and overall survival (p=0.003) in high PHA response group.
Conclusion:
Higher pre-treatment PSIG response, assayed by IGRA testing, was associated with better disease control rate and survival among advanced NSCLC patients treated with chemotherapy.
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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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P3.01-016 - Factors Associated with Symptoms Improvement and HRQoL for First-Line EGFR-TKIs in NSCLC: A Multicenter Prospective SMILE Study (ID 8750)
09:30 - 09:30 | Author(s): C. Lin
- Abstract
Background:
First-line epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) offer an advantage compared to doublet chemotherapy in progression free survival, tolerability, and quality of life (QOL) in EGFR-mutated advanced non-small cell lung cancer (NSCLC) patients. In Taiwan, gefitinib, erlotinib and afatinib are all reimbursed as first-line therapy. It provides a rare opportunity to investigate factors associated with the extent of symptoms and QOL improvement in real-world patient population.
Method:
We conducted a multicenter, prospective, observational study to evaluate the QOL and disease-related symptoms at baseline, 2, 4, and 12 weeks in EGFR-mutated advanced NSCLC patients with first-line EGFR TKI treatment. QOL was assessed by the instrument of Functional Assessment of Cancer Therapy-Lung questionnaire (FACT-L) and Treatment Outcome Index (TOI) derived from FACT-L. Symptoms assessment was evaluated by the Lung Cancer Subscale (LCS). The mean change from baseline of QoL and LCS score was analyzed by paired t-test.
Result:
The average age was 65.1± 12.5 (range 31.4–92.9) years old, with a larger proportion of females (62.6%) than males, and more never-smokers (74.0%) than ever-smokers. Patients were treated with gefitinib 250 mg (72.4%), erlotinib 150 mg (18.9%) or afatinib 40 mg (8.7%). For FACT-L, the total score was increased by 4.0 ± 15.49 at week 2, 4.9 ± 18.31 at week 4, and 4.1 ± 20.44 at week 12 (all p<0.001). Similarly, increased TOI of 2.4 ± 11.61 (p<0.001), 3.1 ± 13.48 (p<0.001), and 2.4 ± 14.35 (p=0.009) were observed at week 2, 4, and 12, respectively. For LCS, it was slightly increased by 1.7 ± 4.59 at week 2, 2.0 ± 5.48 at week 4, and 1.9 ± 5.35 at week 12 (all p<0.001). In general, subgroup analyses indicate that patients with more than 2 metastatic sites and ex-smokers were associated with clinically meaningful improvement in terms of LCS (change in LCS ≥ 2 points). Other subgroup analyses show that patients with characteristics such as at least 3 metastatic sites, ex-smoker, PS of 1, and treatment with gefitinib group, were associated with improved QOL in terms of TOI and FACT-L.
Conclusion:
In EGFR mutated NSCLC patients, first-line EGFR-TKI treatment was associated with improvement in disease-associated symptoms and QOL. Patients with 2 or more metastatic sites and ex-smokers were associated with symptoms and QOL improvement. In addition, PS of 1 and treatment with gefitinib were associated with clinical meaningful improvement in global QOL.
