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Hisao Imai



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    P1.01 - Advanced NSCLC (Not CME Accredited Session) (ID 933)

    • 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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      P1.01-92 - A Phase II Study of Afatinib Treatment for Elderly Patients with Previously Untreated Advanced NSCLC Harboring EGFR Mutations (ID 13034)

      16:45 - 18:00  |  Author(s): Hisao Imai

      • Abstract
      • Slides

      Background

      The efficacy and safety of afatinib (an epidermal growth factor receptor [EGFR] tyrosine kinase inhibitor) in elderly patients with EGFR mutated non-small cell lung cancer (NSCLC) has not been evaluated. Therefore, the aim of this study was to assess the efficacy and safety of afatinib in elderly chemotherapy-naive patients with NSCLC harboring sensitive EGFR mutations.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We prospectively assessed the clinical effects of afatinib as a first-line treatment for elderly (≥70 years) NSCLC patients with EGFR mutations (exon 19 deletion or exon 21 L858R mutation). All patients were initially administered afatinib (30 mg/day) at ten Japanese institutions.

      4c3880bb027f159e801041b1021e88e8 Result

      Between May 2014 and August 2017, 40 patients (13 men, 27 women) with a median age of 77 years (range, 70–85 years) were included in our analysis. All patients had adenocarcinoma. Dose reduction was recognized in 19 patients. The objective overall response and disease control rates were 72.5% and 100%, respectively, and the median progression-free survival and overall survival were 15.2 months and 30.0 months, respectively. Common adverse events included diarrhea, rash/acne, and anemia. Major grade 3 or more toxicities included diarrhea (12.5%), mucositis (7.5%), and pneumonitis (7.5%), respectively. Afatinib treatment was discontinued owing to adverse events of elevation of amylase in 1, liver dysfunction in 1, rash/acne in 1, nail change in 1, anorexia in 2 patients, pneumonitis in 2, and diarrhea in 2. Two treatment-related death because of pneumonitis occurred.

      8eea62084ca7e541d918e823422bd82e Conclusion

      This is the first study that verified efficacy and feasibility of first-line chemotherapy with afatinib of 30mg/day in elderly patients with advanced NSCLC harboring sensitive EGFR mutations. First-line afatinib of 30mg/day could be a preferable treatment in this population.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 2
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.01-111 - Efficacy and Safety of Cytotoxic Drug Chemotherapy After First-Line EGFR-TKI in Elderly Patients with NSCLC Harboring Sensitive EGFR Mutations (ID 11126)

      12:00 - 13:30  |  Author(s): Hisao Imai

      • Abstract
      • Slides

      Background

      Subsequent therapies confound the ability to discern the effect of first‑line chemotherapy on overall survival (OS). Therefore, the objective of our study was to determine the relationships between progression-free survival (PFS) or post-progression survival (PPS) and OS after first-line EGFR-TKI treatment in , using individual level data.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Between April 2008 and December 2015, we analyzed 68 cases of elderly patients with NSCLC harboring sensitive EGFR mutations treated with first-line EGFR-TKI. The relationships between PFS and PPS with OS were analyzed at an individual level.

      4c3880bb027f159e801041b1021e88e8 Result

      PPS was more closely associated with OS (R2 = 0.54) compared to PFS (R2 = 0.48), based on linear regression. Best response at first-line treatment, PS at the end of first-line treatment and administration of EGFR-TKI rechallenge were significantly linked to the PPS.

      8eea62084ca7e541d918e823422bd82e Conclusion

      PPS has a stronger impact on OS than PFS in elderly patients with NSCLC harboring sensitive EGFR mutations treated with first-line EGFR-TKI. fluenced by treatments subsequent to first-line chemotherapy; however, this remains to be verified with prospective studies.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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      P3.01-43 - Predictive Value of Computed Tomography Characteristics for Nivolumab Response in Pretreated Non-Small Cell Lung Cancer (ID 13054)

      12:00 - 13:30  |  Presenting Author(s): Hisao Imai

      • Abstract
      • Slides

      Background

      The efficacy and safety of nivolumab for the treatment of pretreated non-small cell lung cancer (NSCLC) have been established. We conducted a retrospective multicenter trial to determine the significance of computed tomography (CT) morphologic characteristics as a predictor of nivolumab efficacy for advanced NSCLC patients.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      From April 2013 to March 2017, 78 pretreated NSCLC patients were enrolled. Our radiologist assessed the following tumor characteristics on CT before nivolumab treatment; interstitial septal thickening, peritumoral ground-glass opacity, spiculated margin, air bronchogram, cavity or necrosis, adjacent organ invasion, bulky lymph node (≥ 2.5 cm), and accumulation of small lymph nodes. After nivolumab treatment, objective response rate (ORR), disease control rate (DCR) and progression free survival (PFS) were analyzed with logistic regression and Cox proportional hazards regression models. Patient and CT morphologic characteristics were retrospectively analyzed. Significant parameters identified by univariate analysis were included in a multiple analysis.

      4c3880bb027f159e801041b1021e88e8 Result

      Of the 78 patients, 60 (77%) were male, and 72 (92%) patients were of performance status 0 to 1. Heavy smoking was related to higher ORR than light or never smoking (28% vs 0%, p=0.01).No morphologic characteristics were related to ORR or DCR. Interstitial septal thickening was significantly associated with shorter PFS (p=0.015, 77 vs 126 days). Adjacent organ invasion was also significantly associated with shorter PFS (p=0.047, 72 vs 118 days). However, they were not found to be significant on multivariate analysis.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Interstitial septal thickening and adjacent organ invasion may be negative prognostic factors of nivolumab treatment for NSCLC.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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