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K. Chen



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    MO12 - Prognostic and Predictive Biomarkers III (ID 96)

    • Event: WCLC 2013
    • Type: Mini Oral Abstract Session
    • Track: Medical Oncology
    • Presentations: 1
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      MO12.09 - BIM deletion polymorphism in Asian and treatment outcome to chemotherapy in advanced non-small cell lung cancer (ID 2530)

      10:30 - 12:00  |  Author(s): K. Chen

      • Abstract
      • Presentation
      • Slides

      Background
      BIM deletion polymorphism was reported to be associated with poor outcome to epidermal growth factor receptor (EGFR) inhibitor in advanced non-small cell lung cancer (NSCLC) harboring mutant EGFR gene. Little is known whether BIM deletion polymorphism influences treatment outcome to chemotherapy in NSCLC.

      Methods
      We prospectively collect blood samples and clinical data from two independent cohorts of advanced NSCLC patients. The first cohort is composed of 52 patients who received first-line chemotherapies, and the second cohort is composed of 69 patients who received chemotherapy after front-line gefitinib. BIM deletion polymorphism was determined from blood using polymerase chain reaction. EGFR gene was studied in 94 tumors and were classified as wild type, common EGFR mutation (deletion 19 or L858R), or other mutations.

      Results
      The median progression-free survival (PFS) to the first cohort and second cohort were 4.6 and 5.7 months, respectively (p=0.94). The PFS for tumors carrying wild-type, common mutant, and other mutant EGFR genes were 5.8, 4.4, and 7.2 months, respectively (p=0.31). The BIM deletion polymorphism was detected in 19 samples (15.7%). The PFS of patients with normal BIM (solid line of the figure) and BIM deletion polymorphism (dashed line of the figure) were 5.6 and 3.5 months (p=0.03). BIM deletion was related to shorter PFS in tumors carrying mutant EGFR gene (p=0.006) but not those carrying wild-type or other mutant EGFR genes. A multivariate analysis suggested BIM deletion was an independent predictor for shorter PFS to chemotherapy (harzard ratio=2.71, p=0.003).

      variate hazard ratio p-value
      BIM deletion 2.71 0.003
      Male gender 1.57 0.04
      stage IV disease 1.93 0.18
      EGFR mutation 1.0 0.96
      Old age 1.01 0.21
      Figure 1

      Conclusion
      BIM deletion polymorphism is associated with shorter PFS to chemotherapy in advanced NSCLC.

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    P1.10 - Poster Session 1 - Chemotherapy (ID 204)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.10-047 - Clinical Factors Associated with the Efficacy of Pemetrexed as Continuation Maintenance Chemotherapy in Patients with Advanced Lung Adenocarcinoma (ID 2859)

      09:30 - 16:30  |  Author(s): K. Chen

      • Abstract

      Background
      Pemetrexed maintenance therapy significantly improved survival in patients with advanced nonsquamous non-small cell lung cancer. This study was to investigate the clinical characteristics and to identify the prognostic factors of pemetrexed as continuation maintenance chemotherapy for patients with advanced lung adenocarcinoma.

      Methods
      Patients with advanced lung adenocarcinoma treated with pemetrexed for continuation maintenance therapy after platinum-based doublet frontline treatment without disease progression were enrolled. The medical records were analyzed for basic characteristics, epidermal growth factor receptor (EGFR) mutation analysis, treatment responses, progression-free survival (PFS) and overall survival (OS).

      Results
      From September 2009 to September 2012, the medical records of 121 patients with advanced lung adenocarcinoma treated with pemetrexed and platinum as first line chemotherapy were reviewed. Sixty-nine patients treated with pemetrexed for continuation maintenance therapy after 6 cycles platinum-based doublet frontline treatment were included. Thirty-five patients (50.7%) were male. The mean of age was 66 ± 13 years old. Twenty-one patients (30.4%) were current or former smoker. The median cycles of pemetrexed as maintenance therapy was 6 cycles (range from 1 to 36 cycles). Elderly patients (age ≥ 70 years old v.s. age < 70 years old, median PFS: 9.6 months v.s. 4.0 months, p=0.002) and patients with lower glomerular filtration rate (GFR) (GFR ≥ 60 ml/min vs. GFR < 60 ml/min, median PFS: 4.0 months vs. 7.9 months, p=0.03) had longer PFS in maintenance phase of pemetrexed treatment. Other clinical factors, including EGFR mutation status, use of cisplatin or carboplatin, gender, smoking history, and treatment response to first-line chemotherapy, had no eventful effect on PFS. However, there was no significant association between OS and these clinical factors.

      Conclusion
      Pemetrexed continuation maintenance therapy may be more beneficial for elderly patients and patients who had lower renal function.