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S. Jiang



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    P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P2.01-006 - Continuing EGFR-TKI in Combination with Regional Chemotherapy Beyond RECIST PD for Patients with Advanced EGFR(+) Non-Small Cell Lung Cancer (ID 916)

      09:30 - 17:00  |  Author(s): S. Jiang

      • Abstract

      Background:
      Local therapy showed promising results for the patient who had an oligo-metastasis after acquired resistance of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs).Our study is to evaluate the efficacy and safety of continuing EGFR-TKI treatment in combination with regional chemotherapy beyond RECIST progression disease (PD) of EGFR-TKI in advanced patients with EGFR mutation-positive NSCLC.

      Methods:
      Advanced NSCLC patients with EGFR mutation who got a locally progressed in central lung lesion after the treatment of EGFR-TKI were included.Patients received EGFR-TKI continually in combination with super-selectedsystemicarterial infusionwith docetaxel (75 mg/m2) every 21 days until disease progression again or unacceptable side effect.Response to treatment, progression-free survival (PFS) 1 (time to RECIST PD), PFS 2(time to PD if EGFR-TKI was extended beyond RECIST PD) andtreatment-related adverse effects (AEs)were analyzed. Patient-reported outcomes were evaluated inall patients who had completed a baselineassessment and at least one post-baseline assessment based on the QLQ-LC13 scales.

      Results:
      A total of 6 patientswere recruited. Patients had the median age of 54.17 years (range, 40-68 years).Two patients achieved partial responses and four had stable disease. Median PFS1was 11.70±8.97 months. Median PFS2 was 5.36±1.47 months.There was one death (none treatment related). OS data are immature. No unexpected side effects were found in our study.Patients reported significantly greater reductions from baseline in the symptoms of cough, hemoptysis, chest pain and dyspnea (P<0.05 for all comparisons).

      Conclusion:
      Continuing EGFR-TKI in combination with super-selected systemic arterial infusion chemotherapybeyond progression for advanced NSCLC patients with EGFR mutation is feasible and warrent further investigation.

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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
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      P2.02-013 - Strategy of Management for Synchronous Pure GGOs Detected in Patients Undergoing Resection for Primary NSCLC (ID 2599)

      09:30 - 17:00  |  Author(s): S. Jiang

      • Abstract

      Background:
      It is quite common to discover some synchronous pure ground-glass opacity (GGO) nodules in other lobes beside the operable primary tumor on initial CT scans, while the appropriate surgical strategy for these pure GGOs remains controversial.

      Methods:
      We included patients with primary tumor lesion and pure GGOs in different lobes between June 2010 and December 2013. The radiographic manifestations of all GGOs, pathologic features of resected GGOs and follow-up outcomes of unresected GGOs were analyzed to make clear which GGOs should be resected concomitantly with the primary tumor.

      Results:
      A total of 59 patients with 72 pure GGOs were included, of which, 29 were resected at the primary surgery and 43 were left behind and followed up. In the resection group, 8 (27.6%) were invasive or minimally invasive lesions, 12 (41.4%) were preinvasive lesions and 9 (31%) were benign lesions. In the follow-up group, 7 nodules grew, and the growth rate was 16.3% (7 of 43) on a per-nodule basis, and 19.4% (7 of 36) on per-person basis. In all, concomitant resection at the primary surgery was considered for 15 of 72 GGOs (8 malignant lesions and 7 growth lesions). Multivariate analysis showed that the initial size was an independent risk factor for these GGOs (P=0.011), and a cut-off value was calculated as 9.9 mm by receiver operating curve (ROC) curve analysis. Tabel Predictors for synchronous GGO nodules which need concomitant resection

      Univariate analysis Multivariate analysis
      P value OR P value OR
      Age at operation 0.056 1.075 0.872 1.01
      Sex 0.279 0.527
      Smoking 0.136 2.667
      Size <0.001 18.733 0.011 10.922
      Location
      LUL Reference
      LLL 0.345 0.333
      RUL 0.217 0.381
      RML 0.577 1.778
      RLL 0.886 0.889
      Location of primary lesion
      Ipsilateral Reference
      Contralateral 0.334 1.8
      Shape
      Round Reference
      Oral 0.584 1.625
      Irregular 0.349 2.275
      Margin
      Smooth Reference
      Lobulated 0.629 1.4
      Spiculated 0.125 3.111
      Air bronchogram 0.001 8 0.355 2.199
      Bubble lucency 0.024 6.545 0.274 3.356
      Pleural tag 0.006 6.933 0.175 3.724
      Figure 1



      Conclusion:
      About 20% of synchronous pure GGO nodules should need surgical treatment at the time of primary operation, and a lesion size of more than 9.9 mm is an effective discriminator of these GGOs. As to the unresected GGOs, a close follow-up is always indispensible.