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H. Asahina



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    P1.15 - Poster Session 1 - Thymoma (ID 189)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Thymoma & Other Thoracic Malignancies
    • Presentations: 1
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      P1.15-003 - Phase II study of amrubicin (AMR) and carboplatin (CBDCA) for invasive thymoma (IT) and thymic carcinoma (TC) : North Japan Lung Cancer Group 0803 (ID 951)

      09:30 - 16:30  |  Author(s): H. Asahina

      • Abstract

      Background
      There has been no standard chemotherapy for advanced thymic malignancies including invasive thymoma(IT) and thymic carcinoma(TC) although anthracycline or platinum agents have been commonly used for them. AMR, a new anthracycline agent, was approved for lung cancer in Japan and we had previously conducted some prospective studies of AMR combined with CBDCA for patients with small-cell lung cancer, which revealed this regimen was active with acceptable toxicity. The objective of this study is to evaluate the efficacy and safety of this combination for patients with advanced thymic malignancies.

      Methods
      Patients with histologically confirmed thymic malignancies received AMR (35 mg/m2, day1-3) and CBDCA (AUC 4.0, day1) every 3 weeks. Patients who underwent previous chemotherapy received reduced dose of AMR (30 mg/m2). The primary endpoint was overall response rate (ORR), and secondary endpoints were progression-free survival (PFS), overall survival and toxicity profile. Assuming that ORR of 75% and 45% would indicate the potential usefulness while ORR of 50% and 20% would be the lower limit of interest, with alpha = 0.10 and beta = 0.20, for IT patients and TC patients, respectively, 18 IT patients and 16 TC patients were at least required.

      Results
      From December 2008 to October 2012, 51 patients (18 IT and 33 TC) were enrolled from 20 institutions in Japan. The ORR and disease control rate were 17% and 89% in IT, and 30% and 85% in TC. Median PFS was 7.6 months in both groups. Toxicity was generally moderate and no treatment related death was observed.

      Conclusion
      This is the largest prospective study of chemotherapy for advanced thymic malignancies. AMR combined with CBDCA was effective for TC patients with acceptable toxicities.

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    P2.10 - Poster Session 2 - Chemotherapy (ID 207)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.10-017 - Efficacy of Pemetrexed in advanced non-small cell lung cancer with asymptomatic brain metastases (ID 1118)

      09:30 - 16:30  |  Author(s): H. Asahina

      • Abstract

      Background
      Conventionally, the role of chemotherapy in brain metastases (BM) from non-small cell lung cancer (NSCLC) remains limited. However, some cases in which brain metastases (BM) are responsive to Pemetrexed (PEM) have been recognized recently.

      Methods
      We conducted a retrospective analysis of 74 advanced NSCLC patients who had received PEM-containing regimens in our institution from January 2006 to May 2013.

      Results
      Twenty-seven patients had been diagnosed as having BM before starting chemotherapy of PEM-containing regimens. The patient characteristics were: male/female = 12/15; median age (range) = 63 (25-85) years; smoking status: ever/never = 13/14; performance status: 0/1/2 = 0/26/1; histology: adenocarcinoma/NSCLC-NOS = 26/1; EGFR mutation status: positive/negative/unknown = 12/12/3; prior EGFR-TKI therapy: yes/no = 13/14 ; response to prior EGFR-TKI: CR/PR/SD/PD = 1/8/3/1. Fourteen patients had received any local treatments for BM, consisting of 7 whole brain radiotherapy (WBRT), 6 stereotactic radiotherapy (SRT), 2 stereotactic radiosurgery (SRS) and 2 brain surgery. The PEM-containing regimens administered were; CDDP+PEM/CBDCA+PEM/PEM alone = 2/9/16. The lines of chemotherapy was; 1st/2nd/3rd/4th or later = 5/7/9/6. They received the chemotherapy for a median cycle of 3 cycles (range 1-15). The overall response rate (ORR) was 14.8% (4/27) in total and the cranial response rate regarding BM was 14.8%(4/27), consisting of 1 CR and 3 PR. Of 13 patients who received prior EGFR-TKI, the cranial response rate was 23.1% (3/13). Of 17 patients without any prior local treatments for BM or with disease progression of BM after the prior local treatment, the cranial response rate was 23.5% (4/17).

      Conclusion
      The PEM-containing regimens might be a promising therapy for asymptomatic BM in NSCLC including those who showed resistance to EGFR-TKI.