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Z. Wang
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P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.02-035 - Is There an Optimal Time to Initiate Adjuvant Chemotherapy in Order to Predict the Benefit of Survival in Non-Small Cell Lung Cancer? (ID 2341)
09:30 - 17:00 | Author(s): Z. Wang
- Abstract
Background:
Adjuvant chemotherapy (ACT) improves the survival for completely resected non-small cell lung cancer (NSCLC) patients. However, there are very few reports to explore the correlation between time of initiation of adjuvant chemotherapy (TTAC) and survival.
Methods:
208 completely resected NSCLC patients received adjuvant chemotherapy in Cancer Hospital, Chinese Academy of Medical Sciences from 2001-2010 were analyzed. TTAC was measured from the date of surgery to initiation of ACT. Disease-free survival (DFS) was defined as the duration from the surgery to the time of relapse or last follow-up. Optimal cutoff value of the TTAC was determined by maximally selected log-rank statistics. Survival analysis was performed using Kaplan–Meier estimates, log-rank tests and Cox’s proportional hazards regression analysis. Propensity score matching (PSM) was used, and a survival analysis of the match data was carried out.
Results:
The best discriminating cutoff value of TTAC was the 50th day(Figure 2). According to the cutoff value of 50, patients were divided into 2 groups, group1 (≤50days, n=183) and group2 (>50 days, n=25). Figure 1 shows the baseline characteristics of the two groups of patients before and after PSM .There was significant difference in DFS between the two groups (mDFS: 737days vs. 369days, P=0.005)(Figure 2), and the TTAC was found to be a significant predictive factor for DFS in multivariable analysis (P =0.035).Unfortunately, DFS was not continually significant difference in 22 PSM pairs (mDFS:576days vs. 369days,P=0.122) (Figure 2).Figure 1Figure 2
Conclusion:
TTAC does not appear to be associated with DFS in NSCLC. The conclusion was limited by the small sample size; therefore the number of patients between the groups was not close. Larger sample of cases should be warranted in future.
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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
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.01-061 - A Prognostic Model for Platinum-Doublet Regimens as Second-Line Chemotherapy in Advanced Non-Small-Cell Lung Cancer (NSCLC) Patients (ID 1228)
09:30 - 17:00 | Author(s): Z. Wang
- Abstract
Background:
Poor prognosis of advanced non-small-cell lung cancer (NSCLC) patients and the promising therapeutic effect of platinum urge the oncologists to evaluate the role of platinum-doublet as second-line chemotherapy and establish the definition of platinum sensitivity in NSCLC.
Methods:
We retrospectively analyzed 364 advanced NSCLC patients who received platinum-doublet regimens as second-line chemotherapy after platinum-based first-line treatment. Patients were divided into four groups by their time-to-progression (TTP) after first-line chemotherapy: 0-3, 4-6, 7-12, and >12months group, respectively. Treatment efficacy of patients’ overall survival (OS), progression-free survival (PFS) and response rate (RR), as well as treatment-related toxicity, were compared among the four groups. A prognosis score system was established by Cox proportional hazard model.
Results:
All patients had Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-1. As part of the platinum-doublet regimen,145(39.8%) patients received taxol, 81(22.3%) received gemcitabine, 99(27.2%) received pemetrexed, 32(8.8%) received vinorelbine, 4(1.1%) received etoposide, and 3(0.8%) received irinotecan. The most frequent grade 3/4 toxicity was neutropenia (20.1%) and nausea/vomiting (3.3%).The median follow-up time was 11.0 months. Patients with TTP> 12 months had significant longer survival than the rest of the group after second-line platinum-rechallenge (HR, 0.809; 95% CI: 0.703-0.931;P=0.003).Prognostic score (TAF score) was calculated by adding 1 point each for any of the following: TTP>12 months, age≤60 years, and female, all of which were independent prognostic factors for patient survival (P=0.015, P=0.002, P=0.012, respectively). Median OS were equal to 25.0, 16.0 and 11.0 months for best (2-3 points), intermediate (1 point) and worst (0 point) category, respectively (P<0.0001, Figure 1). Figure 1 Kaplan–Meier curves of overall survival according to patients’ TAF Score. After second-line platinum-based chemotherapy, patients with a TAF Score of 2-3 had significant better survival than those scored 0 or 1 (P<0.0001). Figure 1
Conclusion:
A TAF score of 2 or 3 points indicates a good prognosis if advanced NSCLC patients received platinum-rechallenge after disease progression.
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P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.02-032 - Effect of Age on Adjuvant Chemotherapy after Resection of Non-Small Cell Lung Cancer (ID 2343)
09:30 - 17:00 | Author(s): Z. Wang
- Abstract
Background:
Adjuvant chemotherapy (ACT) improves the survival for completely resected non-small cell lung cancer (NSCLC) patients. However, there are few reports to explore the effect of age on the efficacy of adjuvant chemotherapy of NSCLC after surgery.
Methods:
Patients received adjuvant chemotherapy after surgery in Cancer Hospital, Chinese Academy of Medical Sciences from 2001-2010 were analyzed. Disease Free Survival (DFS) of the two groups of patients was compared in terms of their age. Survival analysis was performed using Kaplan–Meier estimates, log-rank tests and Cox’s proportional hazards regression analysis. Propensity score matching (PSM) was used, and a survival analysis of the match data was carried out.
Results:
The data of 256 patients with stage I to stage Ⅲ NSCLC who underwent completely resection was analyzed. Those two groups,patients aged≤65 years (27~65, n=206) and patients aged＞65 years (66~72, n=50) ,were compared. Figure 1 shows the baseline characteristics of the two groups of patients before and after PSM. There was no significant difference in DFS between the two groups (mDFS: 594 days vs. 554 days, P=0.951) (Figure 2), and the age was not associated with DFS in multivariable analysis (P =0.602). DFS was continually not significant difference in 40 PSM pairs (mDFS: 600 days vs. 554 days, P=0.731) (Figure 2).Figure 1Figure 2
Conclusion:
The results suggest that older patients do not appear a shorter DFS than younger. Thus, elderly patients should not be denied adjuvant chemotherapy based merely on age. The conclusion was limited by the small sample size; moreover, the number of patients between the groups was not close. Larger sample of cases should be warranted in future.
