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Daisuke Eriguchi

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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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      P3.01-24 - The Importance to Switch from EGFR-TKI to Cytotoxic Chemotherapy for EGFR Mutation-Positive Adenocarcinoma (ID 12819)

      12:00 - 13:30  |  Presenting Author(s): Daisuke Eriguchi

      • Abstract


      Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have become the first-line treatment for EGFR-positive non-small cell lung cancer (NSCLC) patients all over the world. Furthermore, EGFR-positive patients who received not only EGFR-TKI but also chemotherapy have good prognosis. However, transition rate from first-line EGFR-TKI to chemotherapy is low.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A total of 229 consecutive patients with adenocarcinoma were treated with EGFR-TKI from January 2010 to December 2016 at Tokyo Medical University Hospital. Among these, 159 patients were analyzed in the present study. After excluding 70 patients (45 patients undergone first-line treatment, 7 received chemoradiotherapy,and 18 received osimertinib). The prognosis according to treatment sequence and the reasons patients could not switch from first-line EGFR-TKIs to chemotherapy were analyzed.

      4c3880bb027f159e801041b1021e88e8 Result

      The median follow-up period was 22.5 months. Of the total 159 patients, 113 (71%) were female, 114 (72%) were <75 years old, and 86 (54%) showed postoperative recurrence. The most frequent subtypes of EGFR were exon 19 deletion in 84 patients (53%) followed by exon 21 L858R in 54 patients (34%). EGFR-TKIs were administered as a first-line therapy in 93 (58%) patients, and chemotherapy was administered in 66 (42%) patients. The most common first administered EGFR-TKI as a first-line was gefitinib in 133 (84%) of 159 patients. Among the 93 patients who were administered EGFR-TKIs as a first-line treatment, 32 (34%) patients transitioned to chemotherapy. The median survival times (MST) of EGFR-TKIs combined with chemotherapy group and EGFR-TKIs alone group were 59.8 months and 22.5 months, respectively (p < 0.001), and MST of patients who received EGFR-TKIs first and chemotherapy first were 38.8 months and 66.4 months, respectively (p = 0.016). The main reasons patients could not transition to chemotherapy was worsening of performance status followed by the patient’s preference.

      8eea62084ca7e541d918e823422bd82e Conclusion

      EGFR-TKIs and chemotherapy led to good prognosis in EGFR mutation-positive adenocarcinoma patients. It is necessary to consider the timing to switch the treatment strategy before PS becomes worse.