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C. Bai

Moderator of

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    JCHS - Joint IASLC - Chinese Society for Clinical Oncology - Chinese Alliance Against Lung Cancer Session (ID 239)

    • Event: WCLC 2015
    • Type: Joint Chinese/ English Session
    • Track: Other
    • Presentations: 14
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      JCHS.01 - Introduction (ID 3451)

      C. Bai, Y. Wu

      • Abstract
      • Slides

      Abstract not provided

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      JCHS.02 - Molecular Epidemiology of Lung Cancer in China (ID 3452)

      B. Han

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      JCHS.03 - Development of New Drugs by Chinese Pharmaceutical Companies (ID 3453)

      Q. Zhou

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      JCHS.04 - Current Status of Molecular Testing in China: Application and Technology (ID 3454)

      S. Lu

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      JCHS.05 - Asian Contributions to Global Drug Development (ID 3455)

      T. Mok

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      JCHS.06 - New Diagnostic Techniques for Lung Cancer (ID 3456)

      C. Bai

      • Abstract
      • Presentation

      Abstract not provided

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      JCHS.07 - First-Line Icotinib Versus Cisplatine/Pemetrexed plus Pemetrexed Maintenance in Advanced NSCLC Patients with EGFR Mutation (ID 3524)

      Y. Shi, L. Wang, B. Han, W. Li, P. Yu, Y. Liu, C. Ding, X. Song, Z. Ma, X. Ren, H. Zhang, G. Chen, N. Wu, C. Yao, Y. Song, S. Zhang, L. Ding, F. Tan, J. Feng

      • Abstract
      • Presentation
      • Slides

      Background:
      Clinical studies with anti-EGFR agents demonstrate that EGFR TKIs play critical roles in the treatment of non-small cell lung cancer, especially in patients with positive EGFR mutation. Icotinib is an oral, selective EGFR TKIs. Phase 3 study showed that icotinib is non-inferior to gefitinib in treating unselected or EGFR-mutated advanced NSCLC patients as second-line therapy but better safety profile, which provide a rationale to examine icotinib in first-line setting. The objective of this study is to evaluate progression-free survival (PFS), overall survival (OS) and safety of icotinib in chemotherapy naïve NSCLC patients with EGFR mutation.

      Methods:
      In this phase 3, open-label, randomized study (CONVINCE, NCT01719536), 285 patients (pathologically confirmed NSCLC, positive 19/21 EGFR mutation, treatment naive) will be 1:1 randomized to receive oral icotinib (125 mg, three times daily) or cisplatine (intravenous [IV], 75 mg/m2, day 1) plus pemetrexed (IV, 500 mg/m2, day 1), patients achieving disease control after 4-cycle chemotherapy continue to receive single pemetrexed (IV, 500 mg/m2, day 1) as maintenance therapy until progression. Randomization will be stratified by performance status (0-1/2), smoking status (smoker/non-smoker), disease stage (IIIB/IV), and mutation type (19/21). A total of 228 events would provide 90% power to detect an HR for PFS of 1 at 2-sided significance level of 0.05. Response will be reviewed by both investigator and independent data monitoring committee. Patient enrollment was completed in June 2014, and the results are expected in June, 2015.

      Results:
      Not applicable

      Conclusion:
      Not applicable.

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      JCHS.08 - Role of T790M Mutation in EGFR-TKI Rechallenge for Patients with EGFR-Mutant Advanced Non-Small Cell Lung Cancer (ID 3525)

      Q. Zhang, F. Niu, E. Ke, N. Zhao, J. Su, Z. Chen, J.-. Yang, C.-. Xu, Y. Wu, Q. Zhou

      • Abstract
      • Presentation
      • Slides

      Background:
      Epidermal growth factor receptor (EGFR) exon 20 T790M mutation may have a predictive role before EGFR-tyrosine kinase inhibitors (TKIs) treatment and it also might have a prognostic role after acquired resistance to EGFR-TKIs. However, its role in EGFR-TKI rechallenge after failure of initial EGFR-TKIs in EGFR-mutant advanced non-small cell lung cancer (NSCLC) remains unknown.

      Methods:
      We retrospectively evaluated the clinical course of 515 EGFR-mutant advanced NSCLC patients who received first generation EGFR-TKIs (gefitinib or erlotinib) from December 2009 to November 2014 at Guangdong General Hospital. Of these 515 patients, 65 patients recieved same EGFR-TKI rechallenge, including 51 patients who underwent rebiopsy and secondary EGFR mutation detection after failure of initial EGFR-TKIs. EGFR detection was performed by Sanger sequencing or Amplification Refractory Mutation System (ARMS) methods. Progression-free survival (PFS) and overall survival (OS) were both calculated from commencement of EGFR-TKI rechallenge. Survival data were analyzed using the Kaplan-Meier method and log-rank test.

      Results:
      EGFR activating mutations still existed in all the 51 patients who received rebiopsy and 18 patients were with T790M mutation while 33 patients were without T790M. The median PFS for the T790M+ and T790M- groups were 1.8 months (95%CI 1.180~2.420) and 2.0 months (95%CI 1.100~2.900), respectively (P=0.261). The median OS for the two groups were 7.7 months (95%CI 6.548~8.852) and 6.8 months (95%CI 4.730~8.870), respectively (P=0.565). No statistical difference was found in PFS or OS between two groups(Figure 1). Fig 1. Kaplan-Meier curves of patients in two groups. (A)Progression-free survival. (B) Overall survival.

      Conclusion:
      EGFR T790M mutation is neither a predictive nor a prognostic factor for first generation EGFR-TKI rechallenge in EGFR-mutant advanced NSCLC patients, indicating that whether T790M occurs or not, same EGFR-TKI rechallenge could not be recommended as a good strategy to overcome the resistance to first generation EGFR-TKIs.

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      JCHS.09 - Circulating Tumor Cells and Evaluation of Targeted Therapy Effect in EGFR Mutation/ALK Translocation Metastatic Non-Small Cell Lung Cancer (ID 3526)

      C. Su, X. Li, S. Ren, C. Zhou

      • Abstract
      • Presentation
      • Slides

      Background:
      Targeted therapies have considerably improved the prognosis of patients with non-small cell lung cancer (NSCLC).Although not precision enough, RESIST criteria was still the most often used response assessment method to reflecting the clinical benefits. We propose a non-invasive, folate receptor (FR)–based circulating tumor cell (CTC) detection approach to interpret treatment response of targeted therapy between baseline and follow-up CTC values in EGFR mutation/ALK translocation advanced NSCLC.

      Methods:
      One hundred and thirty eight patients were enrolled in our study. Peripheral blood was analyzed for CTCs enumeration on negative enrichment by immunomagnetic beads. Changes of CTCs levels were correlated with radiological response. Sequential analyses were conducted to monitor CTC signals during therapy and correlate radiological effects with treatment outcome.

      Results:
      CTCs were detected (≥8.7CTC) in 84.8% of patients. Pretreatment and pro-treatment blood samples from all 118 EGFR-mutant (19deltion:56, L858R:57, G719x:3, L861Q:1, 19 deletion + L858R:1), 14 ALK translocation lung cancer patients and 6 EGFR wild type patients were collected. Of 89 eligible and evaluable patients, baseline CTC counts were not associated with response to treatment by RECIST (P=0.353). There is no difference between exon 19 deletion and L858R of baseline CTC values. (19deletion:19.4 CTCs, L858R:20.9 CTCs,P=0.222) The change of CTCs values increased correlation with radiological response (P=0.042) after treatment of targeted therapy. There is no significant difference between exon 19 deletion and L858R of CTCs values pre and pro EGFR-TKI treatment.(3.32 vs.12.1, P=0.783)

      Conclusion:
      This study confirms the predictive significance of CTCs in patients with EGFR mutation/ALK translocation NSCLC receiving targeted therapy. The change of CTCs value correlated significantly with radiological response. This strategy may enable non-invasive, specific biomarker assessment method for using CTC decreases as an early indication of response to targeted therapy and monitoring in patients undergoing targeted cancer therapies.

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      JCHS.10 - Discussant Special Issue on Tobacco Related Lung Cancer in China- Professors Yi-long Wu and ChunXue Bai guest editors for the Journal Cancer(ISSN:1097-0142) Chair: Prof. Fadlo R. Khuri (editor in chief, Cancer) (ID 3457)

      Y. Wu

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      JCHS.11 - Overview the Publishing of Cancer Special Issue (ID 3458)

      C. Bai

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      JCHS.12 - Challenges of Tobacco Related Lung Cancer in China (ID 3460)

      S.S. Ramalingam

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      JCHS.13 - Progress of Management for Lung Cancer: Focus on China (ID 3461)

      J. Hu

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      JCHS.14 - Q&A (ID 3462)

      • Abstract

      Abstract not provided



Author of

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    JCHS - Joint IASLC - Chinese Society for Clinical Oncology - Chinese Alliance Against Lung Cancer Session (ID 239)

    • Event: WCLC 2015
    • Type: Joint Chinese/ English Session
    • Track: Other
    • Presentations: 3
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      JCHS.01 - Introduction (ID 3451)

      C. Bai

      • Abstract
      • Slides

      Abstract not provided

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      JCHS.06 - New Diagnostic Techniques for Lung Cancer (ID 3456)

      C. Bai

      • Abstract
      • Presentation

      Abstract not provided

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      JCHS.11 - Overview the Publishing of Cancer Special Issue (ID 3458)

      C. Bai

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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    MINI 23 - Lung Cancer Risk: Genetic Susceptibility and Airway Biology (ID 135)

    • Event: WCLC 2015
    • Type: Mini Oral
    • Track: Screening and Early Detection
    • Presentations: 1
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      MINI23.09 - Clinical Application of Computer Assistant Diagnostic System in Probe-Based Confocal Laser Endomicroscopy (pCLE) for Pulmonary Diseases (ID 2408)

      C. Bai

      • Abstract
      • Presentation
      • Slides

      Background:
      Probe-based confocal laser endomicroscopy (pCLE) allows for real-time noninvasive histological imaging via bronchoscopy. Interpreting pCLE images and correlating with pulmonary disease remains challenging. We performed an in vivo study to evaluate the correlation between pathological diagnosis and pCLE imaging of pulmonary disease.

      Methods:
      We sequentially enrolled the patients with undiagnosed lung lesion, and randomly grouped into control group (TBLB and peripheral EBUS) and pCLE group (TBLB + pCLE and peripheral EBUS + pCLE). pCLE was performed with Cellvizio system (Mauna Kea Technologies, Paris, France). All patients were consent to the procedure. Pathologists and pulmonologists reviewed the images by the Columbus Classification (CC). Questionnaires were applied post the procedure to collect patients’ condition. We developed a computer assistant diagnostic (CAD) system to calculate alveolar diameter, vessel diameter and optical density percentage and compare the CAD diagnostic accuracy with CC standard. The CAD system involved image processing methods to calculate the diameters in pixel domain and then transformed them into the real value. Pseudo-color processing was used to show the density percentage of different tissues. And the histogram was also calculated to figure out the distribution alone gray scale.

      Results:
      258 patients enrolled in the study, 98 under pCLE examination, while 160 under control group. Among them 128 lesions were diagnosed as malignant tumor by pathological diagnosis, 87 cases were diagnosed as benign disease. Primary features were observed in the samples using pCLE in the lesion of cancer: The normal alveolar in malignant nodules is smaller than benign nodules. While, the vessel in the malignant nodules is thicker than the benign ones. The cellular structure and vessel domination in various subtypes of lung cancer is different. There was no significance on procedure time between control and pCLE group, as well as patients’ secretion, tolerance and willing for repeat examination.

      Conclusion:
      pCLE can identify lung carcinoma in in vivo procedure with well tolerance and with limit procedure time. As a non-invasive method, pCLE could improve accuracy and avoid unnecessary biopsy. The Computer Assist Diagnosis system could help pulmonologists to better acquire the right image and to differentiate diseases on the site.

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    P3.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 208)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P3.01-010 - Multivariate Survival Analysis of China IRESSA Charitable Aid Project in Shanghai (ID 2671)

      C. Bai

      • Abstract
      • Slides

      Background:
      Since Jan 2007, China Charity Federation launched IRESSA Charitable Aid Project for advanced non small cell lung cancer which oral IRESSA was effective for 6 months and have failed previous chemotherapy or received first line IRESSA for EGFR mutation positive. This study investigated the survival and correlation influencing factor of China Charitable Aid Project in shanghai by COX multivariate analysis .

      Methods:
      A retrospective investigation enrolled advanced non small cell lung cancer patient of IRESSA Charitable Aid Project from Jan 2007 to 30 Jun 2013 at 7 centre in Shanghai . The patients oral IRESSA was effective for 6 months who have failed previous chemotherapy or received first line IRESSA for EGFR mutation positive. IRESSA 250mg QD was taken and prescribed monthly. Tumor assessment was performed every 8 weeks, patients continued to receive IRESSA until disease progression (timely withdraw) or unacceptable toxicity or no benefit from this project which was considered as slower progression(late withdraw). The patient were Followed up until 30 Aug 2014. The primary end point was OS and correlation influencing factor. Using the Kaplan-Meier and COX proportional hazards model analyze the correlation between survival and age, gender, smoking status, pathology, indications and timely withdraw of IRESSA.

      Results:
      A total of 1066 patients were enrolled, the median age was 64, including 339 cases of greater than or equal to 70. Most patients were female (845,79.3%) and no-smokers (992,93.1%), and 94.1% was adenocarcinoma. Indication for second and multiple line patients were 96.1%(1024). The midian PFS was 33 months (95%CI:29.8-36.2),and the MST was 37 months (95%CI:32.5-41.5). COX multivariate analysis revealed timely withdraw group was significantly longer OS ( hazard ration 1.627; 95%CI:1.378-1.922, p=0.000) , more than 70 years old, smoking and indication for second line patient was significantly worse OS (hazard ration 0.692; 95%CI:0.587-0.816, p=0.000; 0.714; 95%CI: 0.531-0.960, p=0.026; 0.498 ;95%CI: 0.265-0.935,p=0.03 respectively.

      Conclusion:
      96.1% of the patient in Iressa charitable aid projects were second or multiple line treatment due to chemotherapy failure, PFS and OS still reached 33 and 37 months, significantly better than the historical reports. The possible reason was enrolled patients with IRESSA effective for 6 months , It could be EGFR mutation positive, of which no-smoking patients ratio were as high as 93.1%, they maybe have a better prognosis. Multivariate analysis showed OS was significantly prolonged in timely withdraw group after disease deteriorate.

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    PRC 01 - Press Conference 1 (ID 196)

    • Event: WCLC 2015
    • Type: Press Conference
    • Track: Other
    • Presentations: 1
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      PRC01.03 - Summary of Joint IASLC - Chinese Society for Clinical Oncology - Chinese Alliance Against Lung Cancer Session - Dr. ChunXue Bai, Session Chair (ID 3616)

      C. Bai

      • Abstract

      Abstract not provided