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Eun Joo Kang



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    OA10 - Right Patient, Right Target & Right Drug - Novel Treatments and Research Partnerships (ID 910)

    • Event: WCLC 2018
    • Type: Oral Abstract Session
    • Track: Targeted Therapy
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 10:30 - 12:00, Room 106
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      OA10.05 - An Open-Label, Multicenter, Phase II Single Arm Trial of Osimertinib in NSCLC Patients with Uncommon EGFR Mutation(KCSG-LU15-09) (ID 14365)

      11:15 - 11:25  |  Author(s): Eun Joo Kang

      • Abstract
      • Presentation
      • Slides

      Background

      Approximately 10% of EGFR mutants harbor uncommon mutations, which represent a heterogeneous group of rare molecular alterations within exons 18-21 and the sensitivity to EGFR TKIs is variable. Osimertinib is a potent irreversible inhibitor of both sensitizing EGFR mutation and T790M. In preclinical data, osimertinib was found to be active against most uncommon EGFR mutants, apart from the exon 20 insertion variant. Here we present the efficacy and safety of osimertinib in patients with uncommon EGFR mutation positive NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Patients with histologically confirmed metastatic or recurrent NSCLC with activating EGFR mutation other than exon 19 deletion, L858R, T790M and insertion in exon 20 were eligible. Patients received 80mg of osimertinib orally, once daily until progression or unacceptable toxicity. Response was assessed every 8 weeks by investigator. The trial was registered with ClinicalTrials.gov, number NCT03424759.

      4c3880bb027f159e801041b1021e88e8 Result

      Between Mar 2016 and Oct 2017, 35 patients were enrolled. Median age was 59, 63% male, 43% never smoker, 97% adenocarcinoma. 63% of patients were treated as first-line therapy. The mutations identified were G719A/C/D/S/X (19, 54.3%) followed by L861Q (9, 25.7%), S7681 (8, 22.9%), and others (3, 8.6%). The overall response rate was 50.0% (95% CI 32.8-67.2) and DCR was 88.9% (95% CI 78.1-99.7). Seven patients (77.8%) with L861Q mutation achieved partial response; 10/19 (52.6%) with G719A/C/D/S/X mutation; 3/8 (37.5%) with S768I mutation. At data cutoff (Apr, 2018), the median PFS was 8.2 months (95% CI 1.9- 14.4) and median duration of response was 9.8 months (95% CI 7.6-12.0). The most common adverse events were rash (n=11, 31.4%), anorexia (n=8, 22.9%), and diarrhea (n=7, 20.0%). Grade 3 or 4 AEs were reported in 8 of 35 patients (23%), but all of AEs were manageable.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Osimertinib showed highly active in NSCLC patients harboring uncommon EGFR mutation with manageable safety profile, consistent with previous reports. Further analysis will be provided.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P1.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 944)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.12-13 - Impact of Chronic Obstructive Pulmonary Disease on the Survival of Patients with Extensive-Disease Small Cell Lung Cancer (ID 13719)

      16:45 - 18:00  |  Presenting Author(s): Eun Joo Kang

      • Abstract
      • Slides

      Background

      Small cell lung cancer (SCLC) is a highly fatal lung malignancy. Cigarette smoking is an important cause of SCLC, and most patients have heavy smoking history. Also, smoking is an established risk factor of chronic obstructive pulmonary disease (COPD). Therefore, patients who are diagnosed with SCLC have high chance to coincide with COPD. However, the coincidence rate of COPD and SCLC are not known well. Moreover, the impact of COPD on the mortality of patients with SCLC, especially for patients with extensive diesase (ED) is not reported yet. Therefore, we conducted investigation of clinical features and survival differences between patients who were diagnosed with SCLC with COPD or patients without COPD.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively reviewed medical records of patients who were diagnosed with SCLC-ED and received treatment between 2002 and 2016 at the Korea University Hospital. Among the 182 patients who were diagnosed with SCLC-ED and received palliative chemotherapy, 125 patients who had pulmonary function test report and previous or current smoking history were included. According to the global initiative for chronic obstructive lung disease (GOLD) classification, COPD was defined as FEV1/FVC <0.70.

      4c3880bb027f159e801041b1021e88e8 Result

      Among 125 patients, COPD was present in 69 (55.2 %) patients. Among the patients with COPD, 48 (69.5%) patients did not know the COPD before the diagnosis of SCLC. Patients in the COPD group were older (mean age ± standard deviation, 68.9 ± 8.2 versus 65.6± 8.4 years; p=0.03). The mean FEV1(L) and predicted percent of FEV1 were 1.7L (67.9%) in COPD group and 2.9L (81.2%) in non-COPD group. Gender, body mass index, amount of smoking, ECOG performance status and neutrophil to lymphocyte ratio were not different between the two groups. Median overall survival of all patients was 8.6 months (95% confidential index [CI], 7.7-9.5). Median overall survival of the first-line chemotherapy between patients with COPD and patients without COPD was not statistically different (p=0.382). Median progression-free survival of the first-line chemotherapy between the two groups also were not different (p=0.372). In the analysis of COPD group, FEV1(L) and predicted percent of FEV1 did not affect survival among the patients with COPD (p=0.289).

      8eea62084ca7e541d918e823422bd82e Conclusion

      In conclusion, the presence of COPD at the diagnosis of SCLC-ED does not affect survival outcome in patients who were treated palliative chemotherapy. Even though the patients have severe obstructive pulmonary disease, active chemotherapy has to be considered with priority for the patients with SCLC-ED.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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