Virtual Library
Start Your Search
S.W. Lim
Author of
-
+
OA 03 - Mediastinal and Esophageal Tumor: Insight and New Treatment (ID 654)
- Event: WCLC 2017
- Type: Oral
- Track: Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:M. Chida, Jhingook Kim
- Coordinates: 10/16/2017, 11:00 - 12:30, Room 311 + 312
-
+
OA 03.04 - A Phase II Study of Pembrolizumab for Patients with Refractory or Relapsed Thymic Epithelial Tumor (ID 9689)
11:30 - 11:40 | Author(s): S.W. Lim
- Abstract
- Presentation
Background:
No standard treatment exists for patients with thymic epithelial tumor (TET) who progress after platinum-containing chemotherapy. We conducted a phase II study of pembrolizumab in patients with refractory or relapsed TET to evaluate the efficacy and safety.
Method:
Between March 2016 and June 2017, patients with histologically confirmed TET who progressed after at least one platinum-containing chemotherapy were eligible. Patients were excluded if they had an active autoimmune disease requiring systemic treatment within the past one year or documented history of clinically severe autoimmune disease. Patients received 200mg of pembrolizumab intravenously every 3 weeks until tumor progression or unacceptable toxicity. Response was assessed every 9 weeks by investigator. The trial was registered with ClinicalTrials.gov, number NCT02607631.
Result:
Thirty-three patients were enrolled, 26 with thymic carcinoma and 7 with thymoma. 19 (57.3%) patients received two or more prior lines of systemic chemotherapy. Median number of cycles was 8 (ranges, 1-22) and median follow-up was 11.8 months (ranges, 1.6-14.9 months). Of 33 patients, eight (24.2%) achieved partial responses, 17 (51.5%) stable disease, and 8 (24.2%) progressive disease as best response, resulting in overall response rate of 24.2% (7 confirmed PR). The median progression-free survival was 6.1 months for both of thymoma and thymic carcinoma. The most common adverse events of any grade include dyspnea (11 [33.3%] of 33 patients), chest wall pain (10 [30.3%]), anorexia (7 [21.2%]) and fatigue (7 [21.2%]). Treatment-related adverse events ≥ grade 3 associated with immune related adverse events (irAE) include hepatitis (4 [12.1%]), myocarditis (3 [9.1%]), myasthenia gravis (2 [6.1%]), thyroiditis (1 [3.0%]), ANCA-associated rapidly progressive glomerulonephritis (1 [3.0%]), colitis (1 [3.0%]), and subacute myoclonus (1 [3.0%]) except anemia (1 [3.0%]). Eight (24.2%) patients (5 thymoma, 3 thymic carcinoma) discontinued study treatment due to irAE, whereas irAEs were manageable with immediate administration of high dose corticosteroid and other immunosuppressive agents in most of patients (7 of 8 [87.5%]). In 18 (54.5%) patients who had tumor specimens available for correlative biomarker analysis, all of four patients achieved partial response had 50% or more proportion score of PD-L1 immunostaining and higher PD-L1 RNA expression compared with non-responders (p=0.0471).
Conclusion:
Pembrolizumab showed promising antitumor activity in patients with refractory or relapsed TET. Given the relatively high incidence of irAEs especially in thymoma, early detection and management of autoimmune toxicity is essential to ensure feasibility of pembrolizumab treatment in patients with TET.
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
-
+
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)
-
+
P2.07-025 - Increased Antitumor Response to Chemotherapy Administered after PD-1/PD-L1 Inhibitors in Patients with Non-Small Cell Lung Cancer (ID 8707)
09:30 - 09:30 | Author(s): S.W. Lim
- Abstract
Background:
The role of anti-PD-1/PD-L1 inhibitor monotheapy has been demonstrated for advanced non-small cell lung cancer (NSCLC). However, its benefits in terms of response and progression-free survival are limited to small proportion of patients. The successful treatment of advanced NSCLC requires a combination of various treatment modalities. Therefore, this study evaluated whether subsequent chemotherapy administered after immunotherapy (PD-1/PD-L1 inhibitors) (SCAI) would have enhanced antitumor response in patients with NSCLC.
Method:
This study included patients with available response data for their SCAI. We compared the objective response rates of SCIA with those of the last chemotherapy administered before immunotherapy (LCBI).
Result:
In total, 73 patients met the inclusion criteria and were included into the analyses. Among them, 10 patients received PD-1/PD-L1 inhibitors as first-line therapy, and therefore 63 had available response data for LCBI. The ORR of SCAI and LCBI were 53.4% and 34.9%, respectively (P = 0.03). Out of 73 SCAI, 24 were platinum-doublet chemotherapy and 49 were non-platinum monotherapy, and among 63 LCBI, 43 and 20 were platinum-doublet and non-platinum monotherapy, respectively. The ORR for platinum-doublet of SCAI and LCBI were 66.7% (16/24) and 39.5% (17/43), respectively (p = 0.03). The ORR for non-platinum of SCAI and LCBI were 46.9% (23/49) and 25.0% (5/20), respectively (p = 0.09). Figure 1
Conclusion:
The ORR for SCAI was significantly higher than that of LCBI. This data indicate anti-PD-1/PD-L1 inhibitors could make tumors more vulnerable to subsequent chemotherapy.
-
+
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)
-
+
P3.01-023 - First-line Afatinib for Non-Small Cell Lung Cancer in Real World Practice (ID 8947)
09:30 - 09:30 | Author(s): S.W. Lim
- Abstract
Background:
The efficacy of first-line afatinib was demonstrated for epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) in large randomized trials, and it has been approved and reimbursed in South Korea since year 2014. This study evaluated clinical outcomes of afatinib in real world practice.
Method:
Patients treated with first-line afatinib for advanced EGFR-mutant NSCLC in Samsung Medical Center (Seoul, South Korea) from October 2014 to December 2016 were included into the analyses.
Result:
In total, 165 patients were analyzed. One hundred fourteen had deletion in exon 19, 37 L858R, and 14 patients had uncommon EGFR mutations including 4 de novo T790M. Median progression-free survival (PFS) was 19. 1 months (95% CI: 12.3- 25.9 months). There was difference in median PFS according to EGFR mutation type: deletion in exon 19 (19.1 months), L858R (15.8 months), de novo T790M (4.7 months), and uncommon EGFR excepting for T790M (not yet reached) (P = 0.01). Though 112 patients (67.8%) had to reduce afatinib dose from 40 mg per day into 30 mg or 20 mg per day due to adverse events, it did not impair its efficacy in terms of PFS (23.5 months in a reduction group vs. 12.4 months in no reduction group). Among 29 patients with evaluable follow-up brain MRI for non-irradiated brain metastatic lesions, significant response was documented in 22 cases (75.9%). Out of 20 patients who were biopsied again at disease progression (excluding one case with de novo T790M), T790M appeared in 7 the repeat-biopsied specimens (35.0%).
Conclusion:
In the real practice in South Korea, first-line afatinib showed comparable or better efficacy data compared with previous clinical trials.
