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P. Xing
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-025 - Evaluation of Calculating Carboplatin Dosage in Carboplatin–Pemetrexed Therapy in Chinese Patients with Advanced NSCLC (ID 8768)
09:00 - 09:00 | Author(s): P. Xing
- Abstract
Background:
We conducted a study to explore the application of carboplatin in carboplatin–pemetrexed therapy and determine the recommended dose of carboplatin in Chinese patients with chemo-naive advanced nonsquamous nonsmall-cell lung cancer (NSCLC).
Method:
From January 2014 to April 2016, 151 patients with chemo-naive NSCLC, who were treated with carboplatin plus pemetrexed (500 mg/m2), was conducted. The area under the curve (AUC) of carboplatin was back-calculated from actual dosages using the Calvert formula. Patients were divided into two groups according to an AUC ≥4 or an AUC <4, respectively. The primary efficacy endpoint were overall response rate (ORR) and disease control rate (DCR). Adverse events (AEs) were evaluated with NCI-CTCAE 3.0.
Result:
The median AUC of carboplatin was 4.0 (1.8-5.5). A total of 79 patients had an AUC ≥4 and 72 patients had an AUC <4. The ORR and DCR of all patients were 33.8% and 90.1%, respectively. The ORR and DCR were 35.4% and 86.1%, respectively, in the AUC ≥4 group, 31.9% and 94.4%, respectively, in the AUC <4 group. No difference was observed in ORR (p=0.650) and DCR (p=0.086) in the AUC ≥4 or AUC <4 group. Furthermore, no significant difference was observed in all grade or grade ≥3 AEs in the two groups.
Conclusion:
Our study suggested that compared to Western populations, the calculating dosages of carboplatin using the Calvert formula was common insufficient for Chinese populations, fortunately, therapeutic efficacy remained equally. In addition, it was not increased by maintaining the AUC of carboplatin at ≥4.
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P2.01-030 - Real World Study of Bevacizumab-Contained Regimen as First Line Therapy in Chinese Patients with Advanced NSCLC (ID 9019)
09:00 - 09:00 | Author(s): P. Xing
- Abstract
Background:
Bevacizumab has been demonstrated significant survival benefits in addition to chemotherapy in patients with advanced NSCLC from several large scale randomized control trials. We aimed to explore the clinical impact of first-line bevacizumab-contained regimen (B+) versus non-bevacizumab regimen (non-B) for patients with advanced non-squamous non-small cell lung cancer (NS-NSCLC) in the real world setting.
Method:
From July 2009 to December 2016, patients with advanced NS-NSCLC who received first-line therapy with or without bevacizumab were retrospectively collected from Cancer Hospital Chinese Academy of Medical Sciences. Primary outcome was progression-free survival (PFS), and the secondary objectives were objective response rate (ORR), disease control rate (DCR) and safety. Meanwhile exploratory analysis was conducted in each sub-groups regarding to EGFR and ALK status.
Result:
149 patients met selection criteria, 62 in B+ group and 87 in non-B group. Chemotherapy was the based treatment in each group, 57/62 and 71/87 respectively. Median follow-up time was 10.7 months. The baseline characteristics were well balanced. In overall population, median PFS were significantly longer in B+ than in the non-B group: 9.7 vs 7.0 months, HR 0.52, 95% CI 0.30-0.91, P=0.0184. Both ORR and DCR had improved trends in B+ group. In wild type patients, median PFS of B+ group was 11.3 months compared with 5.5 months in the non-B group (HR, 0.43; 95% CI, 0.20-0.91; P=0.0234). In wild-type and unknown population, median PFS was 11.3 months (B+ group) comparing to 6.0 months (non-B group) (HR, 0.53; 95% CI, 0.28-1.02; P=0.0520). The ORR and DCR had consistently similar response in subgroups comparison (Table 1). Safety profile was acceptable in both groups and no new unexpected findings were found. Figure 1
Conclusion:
Our real world analysis further confirmed that bevacizumab-contained therapy as first line treatment was indeed superior in clinical benefits than non-bevacizumab regimen in Chinese patients with advanced NS-NSCLC in a real world.
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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
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.03-004 - Recurrent Response to Advanced NSCLC with Erlotinib Developing Central Nervous System Failure during Gefitinib or Icotinib Treatment (ID 7424)
09:30 - 09:30 | Author(s): P. Xing
- Abstract
Background:
Approximately one-third of non-small-cell lung cancer (NSCLC) patients harboring EGFR mutations develop central nervous system (CNS) metastases as the progressive pattern during EGFR-TKIs treatment. We design this study to evaluate the feasibility and efficacy of erlotinib as the subsequent therapy when intracranial tumor progression occurs during gefitinib or icotinib treatment.
Method:
The study reviewed the clinical data of patients with advanced NSCLC who received erlotinib treatment after CNS progression of gefitinib or icotinib in Cancer Hospital Chinese Academy of Medical Sciences from June 2012 to July 2016.
Result:
In 29 eligible patients, the objective response and disease control rates of erlotinib for intracranial lesions (ICLs) were 10.3% and 86.2%, and for extracranial lesions (ECLs) were 0% and 93.1%, respectively. The median progression-free survival (PFS) of patients treated with erlotinib was 6.28 months (HR 1.729, 95% CI 2.887–9.663) and the median overall survival (OS) was 11.73 months (HR 2.394, 95% CI 7.036–16.422). Synchronous ICLs and ECLs progression in initial EGFR-TKIs treatment (HR 2.467, 95% CI 1.029-5.915, P=0.043) was found to be an independent adverse prognostic factor for PFS of erlotinib. The patients who received ≥ 2 lines of treatment before erlotinib had a poorer PFS (HR 3.340, 95% CI 1.369-8.152, P=0.008) and OS (HR 2.563, 95% CI 1.025-6.412, P=0.044). The median intracranial progression-free survival (iPFS) for initial EGFR-TKIs was 14.22 months (range, 0.56-35.12 months) and showed no significant difference in PFS and OS of erlotinib re-treatment in subgroup analyses. As for safety profile, the most common adverse events of erlotinib were hematological (44.8%), gastrointestinal reaction (20.7%) and rash (37.9%) in grade 1/2.
Conclusion:
Erlotinib can be used when intracranial tumor progression occurs during gefitinib or icotinib treatment. The progressive pattern of initial EGFR-TKIs and multiple prior treatments may influence the survival of patients with erlotinib re-treatment. Prospective studies are needed to confirm these results.
