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Reina Imase
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P1.03 - Chemotherapy/Targeted Therapy (ID 689)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.03-010 - Efficacy and Safety of Anaplastic Lymphoma Kinase (ALK) Tyrosine Kinase Inhibitors in ALK-Positive Non-Small Cell Lung Cancer (ID 9244)
09:30 - 16:00 | Presenting Author(s): Reina Imase
- Abstract
Background:
Anaplastic lymphoma kinase (ALK) gene rearrangements occur in 3-5% of non-small cell lung cancer (NSCLC) cases. ALK tyrosine kinase inhibitors (ALK-TKIs), such as crizotinib and alectinib, are recommended for the treatment of ALK-positive NSCLC. However, acquired resistance to the ALK-TKIs develops after treatment with these agents. Therefore, it is necessary to consider the alteration of the therapeutic approach against ALK-positive NSCLC. This investigation, reviewed patients with ALK-positive NSCLC treated at Hiratsuka Kyosai Hospital in 2016, to determine the efficacy and safety of ALK-TKIs in this setting.
Method:
The medical data of 11 patients who had been diagnosed with ALK-positive advanced NSCLC and treated with ALK-TKIs at Hiratsuka Kyosai Hospital in 2016 were reviewed retrospectively.
Result:
A total of 11 patients (3 males and 8 females; mean age: 62 years) with ALK-positive NSCLC were investigated. All the pathological types were adenocarcinomas. Eight patients were treated with crizotinib as first-line therapy, and 3 out of those patients were treated with alectinib as second-line therapy. The remaining 3 patients were treated with alectinib as first-line therapy. The overall response rate was 87.5%, and the median progression-free survival was not reached. Four patients had developed PD while receiving crizotinib. Two out of those patients have developed brain metastasis, and were administered local radiotherapy to the brain. Patients who progressed following treatment with ALK-TKIs, were treated with pemetrexed-based chemotherapy. Although adverse events (AEs) of crizotinib were more than those of alectinib, most of them were of Grade 1 to 2 severity. Most common AEs of crizotinib included vision disorder (62.5%), diarrhea (50%), elevated aminotransferases (50%), and nausea (37.5%). Grade 3 to 4 adverse events were reported in 4 cases. However, all of them were controlled by withdrawal of treatment or reduction of dosage.
Conclusion:
ALK-TKIs demonstrate good efficacy and safety in patients with ALK-positive NSCLC.
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P2.03 - Chemotherapy/Targeted Therapy (ID 704)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.03-032 - Efficacy and Safety of Osimertinib as Third-Line or Later Therapy for T790M-Positive Advanced Non-Small Cell Lung Cancer (ID 9172)
09:30 - 16:00 | Author(s): Reina Imase
- Abstract
Background:
Advanced lung adenocarcinoma with epidermal growth factor receptor (EGFR) gene mutation in exon 18 to 21 is sensitive to EGFR tyrosine kinase inhibitors (TKI) such as gefitinib, erlotinib, and afatinib. However acquired resistance to EGFR-TKI develops after initial treatment, primarily due to T790M mutation. In March 2016, the Japanese Ministry of Health, Labour and Welfare approved osimertinib for the patients with advanced non-small cell lung cancer harboring a T790M mutation. In the same year, patients with a T790M secondary mutation were reviewed at Hiratsuka Kyosai Hospital for a period of 9 months. All patients were previously treated with an EGFR-TKI (with or without or prior/subsequent chemotherapy).
Method:
Data were obtained retrospectively by analysis of the medical records of patients who underwent molecular diagnostic testing for T790M mutation. All patients had stage IV adenocarcinoma.
Result:
A total of 8 patients with T790M mutation were identified. Molecular testing was performed using re-biopsy specimens of the primary tumor, metastatic lymph node, or circulating DNA in the plasma of patients. Seven out of 8 patients received osimertinib 80mg once daily. All patients treated with osimertinib received other treatments previously, including EGFR-TKI and standard chemotherapy. The overall response rate (ORR) was 87%. Most common adverse events included diarrhea (28.6%), rash (14.2%), nausea (14.2%). Adverse events of Grade 3 to 4 severity were not reported.
Conclusion:
These findings suggest that third-line or later osimertinib for advanced lung adenocarcinoma with T790M results in high ORR and managed tolerability. The use of molecular testing may improve treatment outcome in these patients.
