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Hirotsugu Kenmotsu

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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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      P3.01-54 - A Historical Comparison of Patients with Advanced NSCLC Harboring Uncommon EGFR Mutations Before and After the Approval of Afatinib in Japan (ID 12711)

      12:00 - 13:30  |  Author(s): Hirotsugu Kenmotsu

      • Abstract
      • Slides


      Afatinib demonstrated durable responses in patients with metastatic non-small cell lung cancer (NSCLC) harboring uncommon non-resistant epidermal growth factor receptor (EGFR) mutations (G719X, L861Q, and/or S768I) in a pooled analysis of three clinical trials. However, the clinical impact of afatinib therapy in patients with these uncommon EGFR mutations remains unclear.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively evaluated patients with advanced NSCLC whose tumors have uncommon EGFR mutations, and who had received first-line systemic therapy at the Shizuoka Cancer Center between January 2010 and December 2017. Patients with resistant EGFR mutations (T790M, exon 20 insertions) and patients who had received investigational EGFR-TKIs were excluded from this study. Characteristics, therapy regimens and survival outcomes were compared between patients who had received a systemic therapy before (Group A) and after (Group B) the approval of afatinib in Japan. Overall survival (OS) was measured from the first day of first-line systemic therapy until death or the final day of the follow-up period.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 23 patients (11 in Group A, and 12 in Group B) were included in this study. The characteristics of the 23 patients were: median age 69 years (range: 41 to 82); 39% male; 26% performance status (PS) 0, 57% PS 1, 13% PS 2 and 4% PS3; 48% with brain metastasis; and 57% current or former smokers. With regard to EGFR mutation type, 30% had G719X, 30% had L861Q, 5% had S768I, 22% had a complex of uncommon mutations, and 13% had both uncommon and common mutations. Patient characteristics were similar in the two groups except for PS. First-line systemic therapy regimens were: gefitinib 73%, erlotinib 9% and platinum-doublet chemotherapy 18% in Group A; gefitinib 8%, erlotinib 25% and afatinib 67% in Group B. Median OS was 10 months for Group A and 25 months for Group B. A significant difference in OS was observed between the two groups (P = 0.018). In a subgroup analysis of patients with PS 0 or 1, there was also a significant difference in OS between the two groups (median, 10 months for Group A vs. 25 months for Group B; P = 0.033).

      8eea62084ca7e541d918e823422bd82e Conclusion

      After the approval of afatinib in Japan, a majority of patients with advanced NSCLC harboring uncommon EGFR mutations received afatinib therapy as first-line systemic therapy, and it may be related to OS improvement.


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