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T. Ishida



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    P2.01 - Advanced NSCLC (ID 618)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P2.01-001 - Serum Albumin Level Predicts the Survival Benefit of Chemotherapy in Elderly Advanced NSCLC Patients with Poor Performance Status (ID 7326)

      09:00 - 09:00  |  Author(s): T. Ishida

      • Abstract
      • Slides

      Background:
      There have been few data on the chemotherapy in elderly advanced non-small cell lung cancer (NSCLC) patients with poor performance status (PS), and usefulness of chemotherapy for such patients remains unclear.

      Method:
      All consecutive patients with advanced NSCLC, elerly (≥75 years old), ECOG PS ≥2, EGFR mutation negative/unknown, and newly diagnosed from January 2009 to December 2012 at Kurashiki Central Hospital, were retrospectively reviewed to clarify the factors which predicts the survival benefit of chemotherapy.

      Result:
      59 patients were enrolled. 31 patients received at least one chemotherapy regimen (chemotherapy group), whereas 28 patients received best supportive care (BSC) alone (BSC group). The proportion of PS 2 and serum albumin level were significantly higher in the chemotherapy group than in the BSC group. The overall survival (OS) was longer in the chemotherapy group than in the BSC group (median OS of 4.7 months and 3.1 months, p = 0.0119). In the chemotherapy group, log-rank testing did not show statistically significant differences in OS between single-agent therapy group and carboplatin-based doublet therapy group, whereas the OS of the patients who received chemotherapy for only 1 cycle was significantly better than those of the patients who received chemotherapy for ≥ 2 cycles. Hypoalbuminemia was not only the risk factor for the early termination of chemotherapy, but also the independent prognostic factor in the chemotherapy group. A receiver operating characteristic curve analysis showed that the best cut-off value was 3.40 g/dl. In the patients with serum albumin ≥ 3.40 g/dl, OS was significantly longer in chemotherapy group than that in BSC group (p=0.0156), whereas, the patients with serum albumin < 3.40 g/dl exhibited poor prognosis regardless of presence/absence of chemotherapy. Figure 1



      Conclusion:
      In the elderly advanced NSCLC patients with poor PS, serum albumin level may help identify the patients who are more likely to benefit from chemotherapy.

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    P2.07 - Immunology and Immunotherapy (ID 708)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Immunology and Immunotherapy
    • Presentations: 1
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      P2.07-024 - Real-World Data of Nivolumab for Previously Treated Non-Small Cell Lung Cancer Patients in Japan: A Multicenter Retrospective Cohort Study (ID 8699)

      09:30 - 09:30  |  Author(s): T. Ishida

      • Abstract

      Background:
      Real-world data in non-small cell lung cancer (NSCLC) patients treated with nivolumab are currently lacking. This study aimed to obtain a detailed understanding of the characteristics and outcomes of these patients.

      Method:
      We retrospectively analyzed data for stage IIIB-IV (7th edition) NSCLC patients treated with nivolumab between January 2016 and January 2017.

      Result:
      A total of 394 patients were included in the study. Most patients had a PS of 0 or 1 (76%) and non-squamous histology (80%). Epidermal growth factor receptor (EGFR) gene mutations were detected in 16% of all patients. Two hundred and seventy-two patients (69%) had received ≥ 2 prior systemic therapies. Response rate was 20.8 %, and median progression-free survival (PFS) was 2.2 months. Estimated PFS and overall survival (OS) at 1-year were 17 % and 55 %, respectively. Multivariate analysis using Cox proportional hazards models identified poor performance status (PS 2-4) and EGFR mutation as independent predictors of PFS (hazard ratio [HR] 2.17; 95% confidence interval [CI], 1.68 to 2.80, P<0.001; HR 1.44; 95% CI, 1.02 to 2.02, P=0.04, respectively). In 255 patients without these negative predictive factors for PFS, response rate was 27.3 %. In these patients, estimated PFS and OS at 1 year were 23 % and 64 %. Severe immune related adverse events (≥Grade 3) were identified in 11.2 % of all patients, and 8.3 % of the patients developed pneumonitis (any grade). Overall incidence of pseudoprogression was approximately 2 %.

      Conclusion:
      Nivolumab has demonstrated a favorable efficacy and safety profile in real-world patients. Poor PS and EGFR mutation positivity were independent negative predictive factors for PFS. Importantly, pseudoprogression was rare in real-world patients.