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P.H. 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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      P2.01-045 - Clinical Experience on Treatment of Advanced Lung Adenocarcinoma With Unknown EGFR Gene Status From a Tertiary Care Center in China (ID 1507)

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

      • Abstract

      Background:
      Limited data are available on treatment experience in patients with advanced lung adenocarcinoma with unknown EGFR gene status (UN-EGFR-GS). We studied the demographic profile and treatment outcomes of advanced NSCLC patients with adenocarcinoma, which the EGFR gene status was unknown.

      Methods:
      Retrospective study of patients with UN-EGFR-GS advanced lung adenocarcinoma over a 4-year period at a tertiary care institute in China. Patients diagnosed with stage IIIb or IV were included for analysis during 2009 and 2012.

      Results:
      In total, 113 patients were included, females and males constituted 46.9% (n=53) and 53.1% (n=60), respectively. Among the 113 patients, 53 were non-smokers and 60 were smokers. The median age was 57.5y(35y-85y). The performance score was 2 in only 12 patients, otherwise was 0 or 1. Majority of patients had stage IV disease (95.6%). Seventy-five patients were advanced stage when diagnosed, and 38 patients were relapsed disease once received surgical resection. Nine patients received adjuvant chemotherapy, which were not relapsed in 6 months after finishing last cycle. The common regimens of first-line treatment were gemcitabine plus platinum (n=36) and pemetrexed plus platinum (n=32). Eleven patients received EGFR-TKIs as first-line treatment. Other drugs included docetaxel, paclitaxel, novelbine and etc. The commonest second-line treatment was oral EGFR-TKIs (n=44). Fifty patients received third-line treatment and 19 received fourth-line treatment. At the end of follow-up (2015-3-30), 91 patients were dead and 22 patients were alive or lost follow up. The median survival of this whole cohort was 20.0m (16.1m-24.0m, 95%CI). The overall survival was not associated with sex (p=0.441), performance status (p=0.809) and smoking (p=0.677). Those patients (29.9m, 95%CI; 18.6m-41.1m) who received surgical resection lived longer than the patients (17.8m, 95%CI; 13.8m-21.8m) who were advanced stage when diagnosed (p=0.01). The overall survival was also not associated with the chemotherapy drugs used in the first-line treatment. The patients (19.0m, 95%CI; 11.4m-26.5m) used pemetrexed plus platinum lived no longer than other regimens (20.5m, 95%CI; 13.4m-27.4m) (p=0.272). In the gemcitabine plus platinum group, the median survival was 19.9m (95%CI; 9.2m-30.6m), which was not longer than other regimens (20.0m, 95%CI; 15.4m-27.4m). The p value was 0.404. We also analyzed the influence of oral EGFR-TKIs on overall survival. Those who had a chance taken EGFR-TKIs lived numerically longer than never; the median survival was 24.8m (19.1m-30.5m, 95%CI) and 16.3m (12.7m-19.9m, 95%CI), respectively. However, the overall difference was not significant (p=0.184).

      Conclusion:
      The median survival of patients with advanced lung adenocarcinoma with UN-EGFR-GS was 20m. Oral EGFR-TKIs appear to be useful for this group of patients.