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M.S. Chatwal
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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
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.01-011 - Relationship between EGFR Mutation Status and Response to Specific Chemotherapeutic Agents in Patients with Stage IV Non-Small Cell Lung Cancer (ID 2491)
09:30 - 17:00 | Author(s): M.S. Chatwal
- Abstract
Background:
The purpose of this study was to investigate whether outcomes with various chemotherapy regimens were affected by the specific epidermal growth factor receptor (EGFR) mutations in patients with stage IV non-small cell lung cancer (NSCLC).
Methods:
We retrospectively analyzed the association between the different EGFR mutations (exon 19 deletion, exon 21, and 18 mutations) and their response to chemotherapy. A total of 17 patients with stage IV NSCLC treated at Winship Cancer Institute of Emory University between January 2007 and February 2015 who received chemotherapy were investigated retrospectively, and their clinical date were assessed according to EFGR mutation.
Results:
14 (82.4%) females and 3 (17.6%) males were identified harboring EGFR mutations. Median age at the time of diagnosis was 66 years (SD 14.08). 12 patients (70.6%) were never smokers, and 5 (29.4%) were former or current smokers. EGFR exon 19 deletion was present in 7 patients (41.2%), exon 21 mutation in 8 (47.1%), and exon 18 in 2 (11.8%). 15 (88.2%) received chemotherapy, and 11 (64.7%) received pemetrexed-based treatment. Four patients had partial response (PR) as the best response to pemetrexed-based chemotherapy, and all of them harbored exon 21 mutation. Among patients that received other types of chemotherapies (paclitaxel, gemcitabine, navelbine and platinum), 6 with exon 21 mutation, and 2 with exon 19 deletion experienced PR. Progression-free survival (PFS) was not significantly different among the groups of mutation (p=0.3645) that received paclitaxel, gemcitabine, navelbine and platinum as chemotherapies, and PFS was also not different for pemetrexed-based regimen (p=0.4569).
Conclusion:
We did not find differential sensitivity to various chemotherapy agents based on mutation type in advanced NSCLC patients harboring an EGFR mutation.
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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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P3.01-003 - Patterns of Disease Progression for Stage IV NSCLC While on PD-1 Directed Therapy as Compared to Standard Chemotherapy (ID 3052)
09:30 - 17:00 | Author(s): M.S. Chatwal
- Abstract
Background:
Programmed Cell Death 1 (PD-1) inhibitor therapy is now an established therapeutic modality in certain solid malignancies, including non-small cell lung cancer (NSCLC). The purpose of this study is to determine whether disease progression patterns are different between PD-1 inhibitor therapy or chemotherapy in patients with advanced NSCLC.
Methods:
We performed a retrospective analysis of patients who received PD-1 targeted therapies and systemic chemotherapy for advanced NSCLC treated at the Winship Cancer Institute at Emory University. We reviewed demographic data and treatment history of these patients. RECIST criteria were used to evaluate the patients’ baseline tumor burden and their subsequent disease progression from imaging studies (CT, PET/CT, MRI).
Results:
The total cohort included 37 patients with a mean age of 67 years. The PD-1 therapy group included 19 patients (14 males, 5 females), with 9 on MK-3475, 3 on MDPL3280A, and 7 on nivolumab. This group included 3 African Americans and 16 Caucasians. The median number of lines of prior chemotherapy was 3. A comparator group of 18 patients on standard chemotherapy was identified (14 males, 4 females). This group included 8 African Americans and 10 Caucasians. In the PD-1 therapy group, 5 patients had no progression and 14 had disease progression. Of these, 5 progressed at their sites of known cancer (36%), 4 progressed at new sites (28.5%), and 5 progressed at both old and new sites (36%). In the chemotherapy group, 4 patients had no disease progression and 14 had progression. Of those 14, 2 were at old sites only (14%), 4 were at new sites only (29%), and 8 were at both old and new sites (57%). The median time to progression was 3.5 months with PD-1 targeted therapy (range 2-13 months) and 6 months with chemotherapy (range 2-21 months).
Conclusion:
Our data suggests no difference between the progression patterns between PD-1 inhibitor therapy and standard chemotherapy patients. Patients on PD-1 therapy appear to have a shorter time to progression than those on traditional chemotherapy.
