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S. Hong
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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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P2.03-022 - Impact of EGFR Mutation on Clinical Outcome of Nintedanib plus Docetaxel in Previously Treated Non- Small Cell Lung Cancer (NSCLC) (ID 8720)
09:30 - 16:00 | Author(s): S. Hong
- Abstract
Background:
Anti-angiogenic agents have been reported to have clinical activity EGFR mutant NSCLC with/without EGFR Tyrosine kinase inhibitor (TKI). We reported clinical outcomes of nintedanib plus docetaxel in refractory NSCLC according to EGFR mutation status during a Korean nintedanib NPU program.
Method:
Patients with NSCLC were eligible if they failed at least one prior systemic treatment. Docetaxel was administered either 75mg/m[2] or 37.5mg/m[2] on D1, D8 q every 3weeks plus nintedanib 200mg orally twice daily. Nintedanib treatment was continued until disease progression or unacceptable toxicity after 4-6 cycles of combination therapy.
Result:
62 patients were enrolled. 28 patients with activating EGFR mutation (17 in exon19 deletion, 8 exon21 L858R/L861Q, 1 exon 18 G719X, 1 in exon20 duplication, 1 in exon19 deletion and exon20 T790M) progressed after EGFR-TKI, 25/28 patient also progressed after platinum doublet chemotherapy were enrolled. Only for 2 patients EGFR mutation status were unknown. Patients were heavily pretreated, with 38.7% patients receiving nintedanib plus docetaxel as ≥ 4[th] line therapy. 5 patients had received bevacizumab. For patients with response assessment reported objective response rate was 30.6% and median PFS and OS were 3.9 months (95% CI 3.4-4.4) and 11.7months (95% CI 5.2-18.1) respectively in overall patients. Based on EGFR mutation status, objective response rate was 52.1% vs 24.1% (EGFR mut(+) vs EGFR mut (-), p=0.47) and median PFS was 5.9 vs 3.6 months (EGFR mt(+) vs EGFR mt(-), p=0.031). No treatment related death was reported. Common grade 3/4 adverse event were neutropenia (33.8 %), and reversible elevated liver enzyme(9.7%). 10 patients in 150mg twice daily and 2 patients with 100mg twice daily administered grade 3 adverse events. Figure 1
Conclusion:
Nintedanib plus docetaxel was well-tolerated and had clinical activity in refractory NSCLC. Specifically, EGFR TKI resistant EGFR mutant NSCLC may be a good candidate for nintedanib plus docetaxel.
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P3.08 - Locally Advanced Nsclc (ID 724)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.08-003 - Multimodal Treatment in the Initially Inoperable Stage III N2 Non-Small Cell Lung Cancer Patients (ID 10088)
09:30 - 16:00 | Author(s): S. Hong
- Abstract
Background:
A multimodal treatment is frequently performed in many initially inoperable stage III N2 non-small cell lung cancer. However, selection of the best treatment for these patients is controversial issue. This study was conducted to explore the benefit of neoadjuvant chemotherapy and adjuvant therapy in these patients.
Method:
Between Jan. 2008 and Dec. 2015, patients with stage III N2 NSCLC enrolled. All of them were treated with induction chemotherapy and surgical resection. Some of them who had high risk factors for disease recurrence underwent adjuvant treatment including chemothearpy, radiothearpy or concurrent chemoradiotherapy.We reviewed medical record including clinicopathologic characteristics and the survival outcome.
Result:
The median age was 65 (range 43-77), and male was more common (M:F, 3.8:1). Median follow-up period was 23.6 months (Range: 3.0-23.6 months). 32 patients (59.%) presented with squamous cell cancer (SqCC), and 20 patients (37.0%) were presented as adenocarcinoma. Docetaxel/cisplatin in 52 patients (96.3%) and gemcitabine/cisplatin in 2 patients (3.7%) were selected as neoadjuvant chemotherapy regimen. The overall clinical response rate to induction chemotherapy was 70.4%. After surgical resection, 27 patients (50.0%) underwent adjuvant chemotherapy alone and 20 patients (37.0%) underwent adjuvant radiotherapy with or without chemotherapy. Median OS was 56.4 months (range 33.5-79.3 months) and median PFS was 24.4 months (ranage 26.6-43.0 months). In multivariable analysis, the adjuvant treatment group showed better survival than the no adjuvant treatment group. Among them, median OS was not reached in adjuvant radiotherapy with or without chemotherapy group and 53.9 months in the adjuvnat chemotherapy alone group (p=0.016).
Conclusion:
Neoadjuvant chemotherapy is active in patients with stage III N2 NSCLC and adjuvant multimodal therapy including chemotherapy or radiotherapy demonstrated favorable survival outcomes. Based on our data, active multimodal neoadjuvant and postadjuvant treatment should be considered for the initially unoperable stage III N2 NSCLC patients.
