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Akihiro Tamiya



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    P2.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 965)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.16-07 - Impact of de Novo T790M on Outcome for Resected NSCLC from EGFR Mutant Cohort of Japan Molecular Epidemiology (JME) Study (ID 13266)

      16:45 - 18:00  |  Author(s): Akihiro Tamiya

      • Abstract
      • Slides

      Background

      We conducted a prospective multicenter molecular epidemiology study (JME study; Kawaguchi T, J Clin Oncol 2016), collecting 876 surgically resected non-small-cell lung cancer (NSCLC) including 373 EGFR mutated cases and examining 72-gene somatic mutations status using the next generation sequencing. We also previously reported pretreatment T790M mutation was detected in 298 (79.9%) of these EGFR mutated NSCLC patients from JME study cohort utilizing the ultra-sensitive droplet digital PCR (Watanabe M, Clin Cancer Res 2015). Here, we report follow-up data and clinical outcomes in the EGFR mutant cohort of JME study and the impact of pretreatment T790M on recurrence free survival (RFS) and overall survival (OS).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      All the patients were enrolled from July 2012 to December 2013, and clinical and prognostic data were obtained until the end of November 2017. Cox proportional hazards model were applied to assess the impact of pretreatment T790M on RFS and OS, considering age, gender, smoking history, histology, stage, history of adjuvant chemotherapy, EGFR mutation status, TP53 and number of coexisting mutations.

      4c3880bb027f159e801041b1021e88e8 Result

      Median follow up time was 48.6 months, and 373 patients were analyzed: 182 were ≥70 years; 97 were men; 93 had smoking history; 361 were adenocarcinoma; 290/43/40 were stage I/II/III-IV; 120 received the adjuvant chemotherapy, 19 had uncommon EGFR mutation, 92/11 had one/two somatic mutations and 69 had TP53 mutation. In RFS, univariate analysis showed event risk tended to be higher in pretreatment T790M positive group than negative group (HR=1.76, 95%CI: 0.98-3.15, p=0.06), but multivariate analysis also couldn’t show significance (HR=1.62, 95%CI: 0.89-2.94, p=0.12). Multivariate analysis showed age (≥70 vs. <70, HR=2.07, 95%CI: 1.34-3.19), gender (male vs. female, HR=1.88, 95%CI: 1.03-3.44), pathological stage (II vs. I, HR=4.10, 95%CI: 2.32-7.21; ≥III vs. I, HR=10.49, 95%CI: 6.07-18.15) and the number of coexisting mutations (2 vs. 0, HR=2.77, 95%CI: 1.07-7.17) were significantly associated with RFS. In OS, although pathological stage (II vs. I, HR=3.61, 95%CI: 1.45-8.96; ≥III vs. I, HR=6.64, 95%CI: 2.92-15.12) was significant prognostic factor, pretreatment T790M positive was not associated with event (HR=1.32, 95%CI: 0.53-3.27, p=0.55).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our study showed pretreatment EGFR-T790M was not a prognostic factor for RFS and OS in surgically resected NSCLC. Cases in younger age, female and less number of coexisting mutations were associated with longer RFS, while earlier stage was significantly associated with both improved RFS and OS in resected NSCLC.

      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: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.01-97 - Which is Better Prognostic Factor, PS, Inflammatory Marker, or PD-L1 Expression in Treating NSCLC with Nivolmab; A Retrospective Analysis (ID 13062)

      12:00 - 13:30  |  Presenting Author(s): Akihiro Tamiya

      • Abstract
      • Slides

      Background

      Although nivolumab showed the significantly longer overall survival (OS) compared with standard second-line therapy using docetaxel for both squamous and non-squamous non-small cell lung cancer (NSCLC) based on two phase III randomized controlled trials, PD-L1 expression alone is not yet an adequate biomarker in treating NSCLC patients with nivolmab. This single institute retrospective study aimed to analyze which biomarker or pretreatment patients’ status were more associated with outcomes in NSCLC patients treated with nivolumab.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively reviewed the medical records of all patients with previously treated advanced NSCLC who received nivolumab between December 2015 and May 2016 in our institute. And we confirmed PD-L1 expression in the patients who were able to examine PD-L1 status. Multivariable logistic regression and Cox proportional hazards models were used to assess the impact of pretreatment PD-L1 expression, performance status (PS), and inflammation parameter (neutrophil-to-lymphocyte ratio (NLR)) on progression-free survival (PFS) and OS. The data cut off was on 31th October 2017.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 66 patients were included in this analysis. Median age was 66 (range, 46–85) years old, 48 patients were men, 54 patients were non-squamous cell carcinoma, 57 patients had a smoking history, 15 patients had a PS of 2 or higher, 23 patients were NLR ≥4, and 10 patients were PD-L1 expression ≥50 and 19 patients were PD-L1 expression 1-49. As for pretreatment prognostic factors, multivariate analyses revealed that never smoker (hazard ratio (HR): 4.22, 95% confidence interval (CI): 1.23 - 15.90), PS ≥2 (HR: 3.72, 95% CI: 1.80 - 7.52), and no PD-L1 expression (HR: 2.03, 95% CI: 1.10 – 3.84) were significantly associated with poor PFS, and furthermore PS ≥2 (HR: 6.27, 95% CI: 2.72 - 14.65) was independently associated with poor OS.

      8eea62084ca7e541d918e823422bd82e Conclusion

      PS is the better prognostic factor than NLR and PD-L1 expression in NSCLC patients treated with nivolumab.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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