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Y. Kondoh
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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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P2.01-037 - Clinical Impact of Interstitial Lung Disease on Advanced Non-Small Cell Lung Cancer (ID 9529)
09:00 - 09:00 | Author(s): Y. Kondoh
- Abstract
Background:
The advanced non-small cell lung cancer (NSCLC) is well known of poor survival. The advanced NSCLC patients with interstitial lung disease (ILD) to be expected poorer survival. The clinical features of patients with advanced NSCLC and interstitial lung disease (ILD) is not fully elucidated, and the role of chemotherapy in advanced NSCLC with ILD remain controversial. The aim of this study was to investigate the prevalence and clinical features of advanced NSCLC patients with ILD, particularly with idiopathic pulmonary fibrosis (IPF).
Method:
We retrospectively analyzed the patients diagnosed with advanced (i.e. stage IIIB and IV) NSCLC at Tosei general hospital, from January 2008 to December 2014. The diagnosis of ILD and IPF were made according to the 2013 and 2011 research statement respectively.
Result:
A total of 899 patients of lung cancer were reviewed, 282 patients were advanced NSCLC. Of these 282 patients, 34 (12%) received the diagnosis of ILD. 22 NSCLC patients (8%) had IPF in 34 ILD. 199/248 of non-ILD NSCLC patients (80%) and 26/34 of ILD NSCLC patients (76%), which includes 17 IPF patients, received chemotherapy. 49/248 (20%) of non-ILD NSCLC and 8 (24%) of ILD NSCLC were treated with best supportive care. There was no significant difference in disease control rate and objective response rate between non-ILD NSCLC and ILD NSCLC patients (72% vs 77%, p=0.696; 33% vs 23%, p=0.271). Overall survival in patients with ILD NSCLC was significantly worse than that in non-ILD NSCLC patients (median survival, 7 months vs 10.1 months; log-rank P=0.013). In patients who received chemotherapy, ILD NSCLC patients had significantly worse survival than non-ILD NSCLC patients (median survival, 7 months vs 10.1 months; log-rank P=0.013). However, there were no significant difference in overall survivals in ILD NSCLC patients between IPF and non-IPF (median survival, IPF-NSCLC vs non-IPF NSCLC: 6.1 months vs 8.2 months; log-rank P=0.375). Among ILD NSCLC patients who received chemotherapy, we found no significant difference in overall survival between IPF NSCLC and non-IPF (median survival, 9.6 months vs 9.7 months; log-rank P=0.275).
Conclusion:
Among advanced NSCLC patients in this cohort, 12% of them had a diagnosis of ILD including 8% with IPF. Survival in advanced NSCLC patients with ILD was worse than that without ILD. We found no significant difference between ILD NSCLC patients with IPF or without IPF in survival.
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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
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.07-053 - A Case of Small Cell Lung Cancer Complicated During Nivolumab Administration as Second Line Treatment for Squamous Cell Lung Cancer (ID 10481)
09:30 - 09:30 | Author(s): Y. Kondoh
- Abstract
Background:
We experience secondary cancer merging after anticancer medications. Also, as a mechanism of resistance of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors to patients with non-small cell lung cancer (NSCLC) harboring activating mutations of EGFR, conversion to small cell lung cancer is well known. However, little is known about the occurrence of secondary cancer during the use of immune checkpoint inhibitors.
Method:
We report a 71 years old man who was diagnosed small cell lung cancer during nivolumab administration as second line treatment for advanced squamous cell lung cancer.
Result:
He suffered from diffuse large B-cell Lymphoma (DLBCL) at the age of 65 years old. He received eight cycles of R-CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone combined with rituximab), and he remitted DLBCL. During his follow up by a hematologist, he pointed out a new nodule in left upper lung and small nodules in right lung with CT scan. He was diagnosed with squamous cell lung cancer by bronchoscopic biopsy. He received four cycles of carboplatin and nanoparticle albumin-bound paclitaxel combination chemotherapy as first line treatment, and he obtained partial response (PR). After 12 months of this treatment, the primary tumor re-increased and relapsed, he received nivolumab as a second line treatment. Although he obtained stable disease by nivolumab, another new lung nodule appeared in right lower lobe gradually. After 12 cycles of nivolumab, he was diagnosed with small cell lung cancer by endobronchial ultrasound transbronchial biopsy with guide-sheath. He received four cycles of combination chemotherapy with carboplatin and etoposide, and he obtained PR. We plan to resume nivolumab as the next line treatment.
Conclusion:
We reported a case of small cell lung cancer complicated during immune checkpoint inhibitor (nivolumab) administration as second line treatment for squamous cell lung cancer. In this case, monotherapy with nivolumab failed to suppress the emergence of small cell lung cancer.
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P3.04 - Clinical Design, Statistics and Clinical Trials (ID 720)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Clinical Design, Statistics and Clinical Trials
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.04-002 - A Randomized Phase II Study of Carboplatin plus Nab-Paclitaxel with or Without Nintedanib for NSCLC with IPF (J-SONIC): Trial in Progress (ID 9627)
09:30 - 09:30 | Author(s): Y. Kondoh
- Abstract
Background:
Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease characterized by worsening dyspnea and progressive loss of lung function. Acute exacerbation of IPF is associated with high morbidity and mortality. Several studies have provided evidence of an association between lung cancer and IPF, with a prevalence of lung cancer in IPF patients ranging from 9.8% to 38%. Although the efficacy of nintedanib for IPF has been demonstrated, it has remained unknown whether this agent also reduces the risk of chemotherapy-induced acute exacerbation of IPF. Patients with interstitial pneumonia have been excluded from most prospective clinical trials for NSCLC because of the risk of acute exacerbation, with only two prospective single-arm phase II studies having been reported. In addition, it has been difficult to perform a randomized prospective clinical trial for patients with advanced NSCLC and IPF because of their rarity. The optimal chemotherapy regimen for advanced NSCLC with IPF has thus remained unclear.
Method:
Chemotherapy-naïve patients with advanced NSCLC associated with IPF (enrollment target of n = 170) are randomized at a 1:1 ratio to receive four cycles of carboplatin (AUC 6 on day 1) plus nab-paclitaxel (100 mg/m[2] on days 1, 8, and 15) administered every 3 weeks either without (arm A) or with (arm B) nintedanib (150 mg b.i.d., daily), to be followed in arm B by single-agent administration of nintedanib (150 mg b.i.d., daily). The primary end point of the study is time to acute exacerbation of IPF.Figure 1
Result:
Section not applicable
Conclusion:
J-SONIC is the first randomized controlled study for treatment of NSCLC associated with IPF. The goal of the study is to demonstrate that nintedanib in combination with carboplatin plus nab-paclitaxel prolongs time to acute exacerbation of IPF compared with carboplatin plus nab-paclitaxel alone. Study enrollment began in May 2017 and is to continue for 3 years.
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P3.12 - Pulmonology/Endoscopy (ID 728)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Pulmonology/Endoscopy
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.12-001 - Lung Cancer in Patients with Interstitial Lung Disease: Clinical Characteristics and Impact on Survival (ID 7477)
09:30 - 09:30 | Author(s): Y. Kondoh
- Abstract
Background:
Lung cancer (LC) is frequently associated with interstitial lung disease (ILD). However, there are few reports about the frequency or prognostic impact of LC in the ILD patients.
Method:
Patients diagnosed with ILD at Tosei general hospital, from January 2008 to August 2015 were retrospectively reviewed, and a total of 1070 patients with ILD had complete clinical and follow-up data.
Result:
Of the 1070 subjects, 65.8% were male, and the mean age was 68 years. Prevalence of histologically proven lung cancer was 5.6% (n=60). Of the 295 patients with idiopathic pulmonary fibrosis (IPF), 491 with Unclassifiable IIPs (UC-IP), 193 with collagen vascular disease IP (CVD-IP), 6.1% (n=18), 6.1% (n=36) and 2.6% (n=5) were affected by lung cancer. The most frequently encountered histologic types of carcinomas were Adenocarcinomas (n=23, 38%), and squamous cell carcinomas (n=21, 35%). Small-cell lung cancer was encountered for eleven cases (18%). Survival in patients with ILD-LC was significantly worse than in patients with ILD without LC (median survival, 39 months vs 96 months; P<0.001). In patients with UC-IP and with CVD-IP, survival in patients with LC was significantly worse than in patients without LC. However, there was not a significant difference in survivals in patients with IPF (median survival, 42 months vs 54.6 months; P=0.35).
Conclusion:
Prevalence of histologically proven LC was 5.6%. The most frequently encountered histologic types of carcinomas were Adenocarcinomas and squamous cell carcinomas . Survival in patients with LC was worse than without LC. However, in IPF patients, there was not significant difference.
