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Ikuo Matsuzaki



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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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      P3.01-42 - Phase II Trial Allowed Surgery After Induction Chemotherapy of CBDCA+PTX, Bevacizumab in Patients with Stages IIIA-IV Nonsquamous NSCLC (ID 11137)

      12:00 - 13:30  |  Author(s): Ikuo Matsuzaki

      • Abstract
      • Slides

      Background

      Surgery remains the best therapy for cure in non-small cell lung cancer (NSCLC). However, the treatment strategy for advanced NSCLC patient including Stage III with N2 remains controversial. Bevacizumab (Bv), a humanized monoclonal antibody targeting VEGF, combined with the standard platinum doublet-based chemotherapy is approved for the first-line treatment of NSCLC. This study aimed to determine whether the treatment allowed surgery after induction chemotherapy of carboplatin (CBDCA) and paclitaxel (PTX) with Bv provides a reduction in the risk of progression in patients with stages IIIA to IV non-squamous NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This clinical trial was an open-label, multicenter, single-arm study involving 10 institutions in Akita, Japan (UMIN000007916). Chemotherapy/radiation-naive patients > 20 years of age, ECOG performance status of 0 to 1, and adequate hematologic, hepatic, and renal function with cytologically or histologically confirmed stages IIIA to IV nonsquamous NSCLC not amenable to surgical resection or radiation with curative intent, were eligible. Treatment plan is showed in Figure 1.

      fig.1 cbdca+ptx, bv schema.jpg

      4c3880bb027f159e801041b1021e88e8 Result

      Between April 2012 and October 2017, a total 29 patients were enrolled. The overall response rate was 72.4%, 10 of 29 patients underwent radical surgery included lymph node dissection 2a-2 basically after the chemotherapy. Complete resection was achieved in 7 patients of them (70%) in the induction chemotherapy group. Bronchial stump and anastomoses were buttressed with a pericardial flap or intercostal muscle flap in some cases. The 30-day hospital mortality was 0% in the all patients who underwent operation. Grade 3 or 4 adverse events occurred in 72.4% such as neutropenia, just one case has pulmonary hemorrhage and GI bleeding.

      8eea62084ca7e541d918e823422bd82e Conclusion

      These results suggest that CBDCA+PTX, Bv which has higher response rate will introduce the better potential to reduce tumor size, increase operability, and eradicate micro-metastases. However, a survival benefit might be limited even though surgery was added after induction chemotherapy.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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