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R. Tian

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    P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P1.01-009 - Combination of Angiogenesis Inhibitor and EGFR-TKIs in Advanced NSCLC Patients Who Developed Acquired Resistance (ID 2218)

      09:30 - 17:00  |  Author(s): R. Tian

      • Abstract
      • Slides

      Several randomized clinical trials have shown that erlotinib and Bevacizumab combination improved the survival of patients with EGFR mutation-positive Non-small cell lung cancer(NSCLC). The aim of this study was to evaluate the clinical activity of another angiogenesis inhibitor Endostar (rh-endostatin) in combination with continued EGFR-TKIs (including erlotinib, gefitinib and Icotinib) for advanced NSCLC patients who have developed acquired resistance to prior EGFR-TKIs treatment.

      Advanced NSCLC patients with disease progression who had partial or complete response to prior EGFR-TKIs treatment received 2-8cycles of Endostar plus EGFR-TKIs. Endostar was administered at a dose of 15mg q.d intravenously for 14 days, each at 3-week intervals; combined with continued EGFR-TKIs (erlotinib 150mg PO daily, or gefitinib 250mg PO daily or Icotinib 125mg PO t.i.d); until unacceptable toxicity or disease progression. The response was assessed using Southwest Oncology Group (SWOG) criteria after 6 weeks.

      A total of 17 NSCLC evaluable patients were enrolled, including 9 women and 8 men. The presence of EGFR status were exon 21 L858R point mutation in 7 cases, exon 19 deletion in 5 cases, wild type in 2 cases and unknown in 3 cases. Median number of treatment cycles was four. It showed a 76.47% (13/17) disease control rate and had a prolonged stabilization of disease (>6 months). Median PFS was 6.9 Months. Treatment benefit and overall survival was noted both in activating EGFR mutation patients, EGFR stated unknown patients and even in wild type patients. One stage VI patient with EGFR wild type, developed resistance after 6 months 2nd line erlotinib treatment, received 8 cycles of Endstar and erlotinib combination, and had 46 months overall survival time. Endostar in combination with EGFR-TKIs were generally well tolerated. The most common adverse events were rash 35.29% (6/17), decreased appetite 29.41% (5/17), dry skin29.41% (5/17). No grade 3 or greater adverse events were seen in this study.

      Endostar with the addition of continuation of EGFR-TKIs has demonstrated promising clinical activity in NSCLC patients selected for acquired resistance to previous use of EGFR-TKIs. Treatment with this combination exhibited a good safety profile. Our results strengthen the evidence that angiogenesis inhibitor may be a valid option for NSCLC patients who have progressed on EGFR-TKIs. The optimal clinical combination and activity warrants further investigation.

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