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Shouzheng Wang



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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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      P3.01-103 - Efficacy of Crizotinib in Chinese Non-Small Cell Lung Cancer Patients with Brain Metastasis: A Multicenter Retrospective Study (ID 12578)

      12:00 - 13:30  |  Presenting Author(s): Shouzheng Wang

      • Abstract
      • Slides

      Background

      Brain metastasis in advanced non-small cell lung cancer (NSCLC) patients is often considered as a terminal stage. Crizotinib is a small-molecule tyrosine kinase inhibitor (TKI) for ALK-rearranged NSCLC patients. Herein we conducted a multi-center retrospective study to explore how crizotinib affects the control of brain metastasis and survival outcomes among advanced ALK-rearranged NSCLC patients with brain metastasis in Chinese population.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We reviewed medical records of 484 unselected ALK-positive NSCLC patients treated with crizotinib at five cancer centers in China from January 2013 to November 2017. Patients developing brain metastasis either before or during the crizotinib treatment were enrolled. Survival outcomes were analyzed with Kaplan-Meier method and prognostic factors were analyzed with multivariate COX analysis.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 174 patients were enrolled into this study, of whom 95 patients had baseline brain metastasis and 79 patients developed brain metastasis during crizotinib treatment. Among patients with baseline brain metastasis, the median intracranial progression-free survival (PFS) was 15.34 months [95% confidence interval (CI): 10.62-20.07] and median overall survival (OS) was 53.38 months (95%CI: 30.58-76.17). The intracranial objective response rate (ORR) was 17.1%, and the intracranial disease control rate (DCR) was 88.6%. Multivariate COX analysis revealed that patients receiving first-line crizotinib [>first-line vs. first-line, hazard ratio (HR): 2.44, 95%CI: 1.05-5.68, p=0.038], withtout intracranial progression during crizotinib treatment (with vs. without intracranial progression, HR: 18.68, 95%CI: 2.43-143.31, p=0.005) were associated with better OS, while age, sex, number of brain lesions, and operation/radiation therapy for brain metastasis were not significantly associated with OS. Among patients developing brain metastasis during crizotinib treatment, the median OS was 35.64 months (95%CI: not reached). Multivariate COX analysis revealed that brain progression only (brain progression only vs. both brain and extracranial progression, HR: 0.23, 95%CI: 0.08-0.71, p=0.011) was associated with better OS, while age, sex, line of crizotinib treatment, treatment after progression and operation/radiation therapy for brain metastasis were not significantly associated with OS.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Advanced ALK-rearranged NSCLC patients with baseline brain metastasis could still benefit from crizotinib treatment. However, brain progression during crizotinib treatment may be associated with worse survival outcomes.

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