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S. Detarkom
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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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P3.01-042 - Efficacy & Tolerability of Afatinib in NSCLC Patients Prior Exposure to 1st Generation EGFR TKI: Thailand Multicenter Study (ID 9455)
09:30 - 09:30 | Author(s): S. Detarkom
- Abstract
Background:
The Compassionate-Use-Program (CUP) was available in Thailand for requesting afatinib during 2012-2014 for patients whom had failed at least one-line of platinum-based-chemotherapy and progressed following at least 6 months on 1[st]-generation EGFR-TKIs. This is a multicenter-retrospective-study in Thailand aimed to explore the efficacy and tolerability of afatinib in this group of patients.
Method:
Full medical-records of 79 patients from 7 institutions were reviewed. Clinical and tumor characteristics were analyzed using descriptive statistics. The efficacy in brain metastases was explored. Survival curves were constructed using the Kaplan-Meier method. All analysis was done in Stata version14.
Result:
Sixty-eight percent of patients were younger than 65 years old, 60% were female, and 67% received more than 2 of prior-regimen. EGFR-mutation was tested in 75% of patients; comprise of 86% common-mutations, 14% uncommon-mutations. Eleven patients had T790M acquired-resistance in combination with sensitive-mutation before receiving afatinib. One patient had De-novo-T790M. The mOS, mPFS, and mTTF were 11.5, 3.9, and 5.1 months, respectively. Eighteen patients had brain-metastases at enrollment and 6 patients had new brain-metastases during afatinib treatment. The mOS, mPFS, and mTTF were not statistically different among new brain-metastases or pre-existing brain-metastases. There was no dose-reduction in 38%, 1 dose-reduction 44%, 2 dose-reductions 12%, and 3 dose-reductions 6% of patients. The mean dose for every patient was 35 mg. Time-to-first-dose-reduction significantly affected the mPFS and mTTF as shown in Table. Furthermore, number of prior-treatment more than 2 was the significant factor causing first-dose-reduction within 1 month and age younger than 65 years-old was the significant factor causing first-dose-reduction within 2 and 3 months in multivariate and univariate model, respectively.Time to 1[st] dose reduction OS PFS TTF Hazard ratio (95%CI) P-value Hazard ratio (95%CI) P-value Hazard ratio (95%CI) P-value > 1 month <= 1 month 1 1.59 (0.74-3.41) 0.23 1 1.52 (0.82-2.82) 0.19 1 1.45 (0.77-2.74) 0.25 >2 month <= 2 months 1 1.54 (0.72-3.3) 0.27 1 2.11 (1.14-3.92) 0.02 1 1.63 (0.88-3.04) 0.12 >3 months <= 3 months 1 2.31 (0.98-5.45) 0.06 1 2.67 (1.38-5.20) 0.004 1 2.12 (1.09-4.12) 0.03
Conclusion:
The mOS, mPFS, and mTTF of our study were comparable with LUX-Lung1 study. Number of prior-treatment and age were the significant factors causing dose-reduction. Taken together with time-to-first-dose-reduction also affected the survival of patients.
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P3.03 - Chemotherapy/Targeted Therapy (ID 719)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.03-020 - Unique Molecular Profile of NSCLC in Thai Population (ID 9847)
09:30 - 09:30 | Author(s): S. Detarkom
- Abstract
Background:
Oncogenic driven mutation is the key to develop targeted therapy in lung cancer. Different ethnicity might have the different prevalence of molecular alteration. This study aimed to explore the unique molecular profile of lung adenocarcinoma in Thai population.
Method:
We studied 120 lung adenocarcinoma patients’ molecular profile by FFPE DNA extraction and using Next Generation Sequencing (NGS) on 45 genes lung cancer panel (Ion Torrent system).
Result:
We found 64% (77/120) of EGFR mutation, 13%(16/120) of BRAF V600E,32% (38/120) of KRAS mutation, 11% (13/120) of MET exon14 splice site, 7.5% (9/120) of AKT mutation (E17K), 2.5% (3/120) of ROS1 mutation, 0.8% (1/120) of PIK3CA mutation (H1047R), and 0.8% (1/120) of PTEN mutation by NGS method using the allele fraction cutoff at 2%. We also found 46 patients (38.3%) who had more than one mutation in each person. The validations by the other technique are on-going and will be presented at the WCLC 2017.
Conclusion:
Adenocarcinoma of the lung in Thai population had the unique molecular profile with high prevalence of BRAF V600E and MET exon 14 splice site comparing to the other populations. High prevalence of KRAS and dual different gene mutations in each patient are needed to be confirmed by the other technique because it could be from the artifact of formalin fixation for G12D, G12S, G13D, and G13S of KRAS mutation.
