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H. Pang



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    Poster Display Session (ID 63)

    • Event: ELCC 2017
    • Type: Poster Display Session
    • Track:
    • Presentations: 2
    • Moderators:
    • Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1
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      165P - Malignant pleural mesothelioma: A systematic review of first-line chemotherapy and analysis of Hong Kong cohort (ID 281)

      12:30 - 13:00  |  Author(s): H. Pang

      • Abstract

      Background:
      Malignant pleural mesothelioma (MPM) is a rare but aggressive cancer. Although the standard first-line chemotherapy for MPM has been established, many different treatments are still under investigation. Additionally, epidemiologic analysis of MPM patients in Hong Kong has not been conducted in recent years.

      Methods:
      To review the progress in first-line chemotherapy treatment for MPM patients between 2010 and 2016, and to study the epidemiology and prognostic factors of Hong Kong MPM patients from 2002 to 2015. A thorough literature search was performed on PubMed and Cochrane Library (CENTRAL), restricted to English papers released between January 2010 and May 2016. Hong Kong MPM patients were identified from Pneumoconiosis Medical Board (PMB) by reviewing medical records. Kaplan-Meier and log-rank tests were used to compare survival between categories. Prognostic factors were identified by Cox regression analysis.

      Results:
      22 studies were included in the review. Pemetrexed/cisplatin is the recommended first-line regime now. Studies suggested that carboplatin plus pemetrexed can be an alternative regimen to reduce toxicity. The addition of bevacizumab to pemetrexed/cisplatin showed promising results and may become a new paradigm. Gemcitabine plus cisplatin, especially administrated in low dose prolonged infusion, showed comparable efficacy with lower cost. From the Hong Kong PMB clinic, 102 MPM patients were identified, with male predominance, mean age of 69.1 years at diagnosis, mean latency of 49 years, median overall survival of 11.7 months and mainly epithelioid histological subtype. Other possible prognostic factors like symptoms of chest pain and dyspnea were explored.

      Conclusions:
      Cisplatin plus pemetrexed, has been supported in routine practices settings. Carboplatin can substitute cisplatin to reduce toxicity. Bevacizumab plus cisplatin-pemetrexed triplet with appropriate management of treatment-related toxicity is the most promising first-line treatment. Hong Kong MPM patients share similarities in terms of prognostic factors with those in the literature.

      Clinical trial identification:


      Legal entity responsible for the study:
      HKU

      Funding:
      Pneumoconiosis Compensation Fund Board

      Disclosure:
      All authors have declared no conflicts of interest.

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      78P - Comparison of chemoradiotherapy treatment strategies in stage III non-small cell lung cancer among elderly patients from multiple data sources (ID 365)

      12:30 - 13:00  |  Author(s): H. Pang

      • Abstract

      Background:
      Comparative effectiveness research can benefit from combining data from multiple sources. This analysis integrally evaluated the survival benefits of combined modality therapies (CMTs) in locally advanced non-small cell lung cancer (NSCLC) based on individual patient data from US and Chinese populations.

      Methods:
      Two patient populations were included. SEER-Medicare cohort consists of 65 years or higher who were diagnosed with stage III (IIIA/IIIB) NSCLC from 2006 to 2010 and received combined modality treatment. Queen Mary Hospital cohort from Hong Kong for aged 65 or higher who were diagnosed with stage III (IIIA/IIIB) NSCLC from 2007 to 2016. The four CMTs of interest were concurrent (CMT-ONLY), sequential chemotherapy followed radiation (CMT-SEQ), induction followed by concurrent (CMT-IND) and concurrent followed by consolidation (CMT-CON) chemoradiation. The primary endpoint for was overall survival. Patients hospitalized for neutropenia were ascertained through inpatient claim with the claim occurring within 130 days after the first chemotherapy. Stepwise multivariable regression models and propensity score adjusted models were used to control confounding variables. We also compared the findings with our previous study based on clinical trials data.

      Results:
      2682 locally advanced NSCLC patients were included. For CMT-ONLY, CMT-SEQ, CMT-IND, and CMT-CON respectively, their corresponding median overall survivals were 13.0 (95% CI 12.0-14.0), 13.0 (95% CI 12.0-16.0), 17.0 (95% CI 15.0-20.0), and 15.4 (95% CI 14.0-17.0) months. CMT-IND and CMT-CON had survival benefit over CMT-ONLY and CMT-SEQ. Patients receiving CMT-SEQ were relatively healthier patients in this study based on the Charlson comorbidity weights. 7.9%, 2.8%, 8.6%, and 9.5% were hospitalized for neutropenia for CMT-ONLY, CMT-SEQ, CMT-IND, and CMT-CON, respectively. CMT-SEQ had a lower hospitalization for neutropenia rate than the other CMTs.

      Conclusions:
      The findings on efficacy and toxicity are quite consistent with previously reported studies based on clinical trials or observational databases.

      Clinical trial identification:


      Legal entity responsible for the study:
      Duke University

      Funding:
      NIH, HMRF

      Disclosure:
      All authors have declared no conflicts of interest.