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B. Yan



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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 2
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      162P - Responses to EGFR TKIs and ALK TKIs in advanced NSCLC patients harboring concomitant EGFR and ALK alterations (ID 503)

      12:30 - 13:00  |  Author(s): B. Yan

      • Abstract
      • Slides

      Background:
      Previous studies indicated that Epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement are mutually exclusive in non-small cell lung cancer (NSCLC). However, cases diagnosed with concomitant EGFR and ALK alterations has been occasionally reported. This study aimed to assess the prevalence of this small subset patients and optimize clinical management.

      Methods:
      We retrospectively collected clinical outcomes of 29 cases who had concomitant EGFR and ALK alterations from 5816 lung cancer patients tested EGFR mutation and ALK rearrangement between 2011–2017 in the Shanghai Chest Hospital. Meanwhile, we identified 103 cases harboring double positive mutations from a literature search. Of these 132 cases, 81 patients received EGFR tyrosine kinase inhibitor (EGFR-TKI) or ALK-TKI treatment.

      Results:
      The frequency of EGFR/ALK co-alterations was 0.5% (29/5816; 95%CI:0.3%-0.7%) in NSCLC in our center. For all 132 cases, there is a prevalence of women (67 female, 46 male, 19 not reported), Asian (87Asian, 44 Caucasian, 1 not reported) and never smoker patients (77 never smokers, 21 smokers, 34 not reported). We divided the patients into three groups according to EGFR or ALK TKIs treatment: A: single EGFR TKI group (36 cases), B: single ALK TKI group (14 cases) and C: both TKIs (31 cases). All patients were assessed for TKIs responses. The disease control rate (DCR) of EGFR-TKI was 81.5%, whereas the DCR of ALK-TKI was 89.1%. The median PFS of three groups were 12.4, 15.9 and 24.1months, respectively (P = 0.02). The PFS of group A and C had statistically sigificant difference (P = 0.006). But the PFS of group A and B, B and C did not have statistical significance (P = 0.338, P = 0.335).

      Conclusions:
      EGFR mutations and ALK rearrangement do coexist in NSCLC. In cases with double positive mutations, our preliminary study suggests that PFS of those who received double TKIs is longer than those who received only one TKI. Combination of both TKIs might be an appropriate choice. The result of the study indicates that ALK TKI might be preferentially administered when TKI is initiated as first-line treatment.

      Clinical trial identification:


      Legal entity responsible for the study:
      Wang shuyuan

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.

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      167P - Efficacy of pemetrexed-based chemotherapy in advanced lung adenocarcinoma patients with ROS-1 rearrangement (ID 413)

      12:30 - 13:00  |  Author(s): B. Yan

      • Abstract
      • Slides

      Background:
      When chemotherapy is commenced as first-line treatment in advanced lung adenocarcinoma patients with ROS-1 rearrangement, it is unclear that which agent should be preferentially administered. The aim of this study is to compare the therapeutic efficacy of pemetrexed-containing (Pem-C) and non-pemetrexed-containing (Non-Pem-C) chemotherapy in these patients.

      Methods:
      We retrospectively identified patients who were demonstrated to be ROS-1 positive by multiplex reverse-transcriptase polymerase chain reaction (RT-PCR) between October 2014 and December 2016. Those who received platinum-based dual agent chemotherapy as palliative treatment were included for further analysis.

      Results:
      A total of 4596 consecutive individuals were screened and 55 eligible individuals were enrolled into this study. In first-line treatment, patients who received Pem-C treatment (n = 39) derived a higher objective response rate (ORR, 40.0% vs. 7.1%, P = 0.02) and progression-free survival (PFS1, 7.0 months vs. 3.9 months, P < 0.01) compared with those who received Non-Pem-C treatment (n = 16). However, in later-line treatment, progression-free survival (PFS2) was not statistically superior in the Pem-C group (3.1 months, 95% CI: 0.6–5.6 months) compared with the Non-Pem-C group (1.9 months, 95% CI: 0.1–3.1 months, P = 0.12).

      Conclusions:
      Pem-C treatment resulted in better clinical outcomes compared with other agents in patients with ROS-1 rearrangement when initiated as first-line treatment.

      Clinical trial identification:


      Legal entity responsible for the study:
      Bo Zhang

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.