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Poster Session (ID 8)
- Event: ACLC 2018
- Type: Poster Session
- Presentations: 2
- Coordinates: 11/07/2018, 00:00 - 00:00, Poster Hall
P030 - Prognostic Factors for Advanced Lung Adenocarcinoma Patients Who Received Tyrosine Kinase Inhibitor and Radiotherapy (ID 94)
00:00 - 00:00 | Author(s): Y. Gong
We sought to identify the independent prognostic factors for survival of the patients with advanced lung adenocarcinoma who respond to first-line tyrosine kinase inhibitor (TKI) and receive radiotherapy
Patients with stage III and IV lung adenocarcinoma who responded to first-line TKI and received radiotherapy in West China Hospital from Dec 1, 2007 to Jan, 1, 2018 were retrospectively enrolled. Univariate and multivariate analysis for prognostic factors including gender, age, stage, brain metastasis status, EGFR mutation type, radiotherapy type, duration between TKI and the staring of radiotherapy, biological equivalent dose (BED) of radiotherapy, and progression status before radiotherapy were analyzed by Cox regression model. Radiation-associated PFS (rPFS) was defined as the date of beginning of radiotherapy to the date of newly disease progression.
Forty-five patients were enrolled in this study and 8 of them received radiotherapy combined with TKI before progression. Among the patients with progression disease, 17 of them received radiotherapy with continuation of TKI, 20 patients were treated with radiochemotherapy and ceased the use of TKI after progression. The median follow-up for all patients was 58.3 month. The median rPFS was 5.4 month (95%CI: 4.4-6.4). The results of univariate analysis showed that higher BED (HR=0.460, 95%CI: 0.239-0.886, P =0.020) and radiotherapy prescribed before disease progression (HR=0.354, 95%CI: 0.135 -0.927, P =0.034) was relevant to longer rPFS. Multivariate analysis revealed that BED (HR=0.464, 95%CI: 0.240-0.899, P =0.023) and progression status before radiotherapy (HR=0.357, 95%CI: 0.135-0.940, P =0.037) were independent predicators for rPFS. No difference of rPFS was found between the patients with conventional radiotherapy or stereotactic body radiation therapy (SBRT) (P=0.450). The median overall survival (OS) was 43.3 month (95%CI: 29.7-56.9). Patients with advanced stage (HR=3.749, 95%CI: 0.883 -15.919, P =0.073) and shorter duration between TKI and the staring of radiotherapy (HR=1.962, 95%CI: 0.892-4.317, P =0.094) tend to have a shorter OS but without statistical significance.
BED of radiotherapy and progression status were independent prognostic factor for rPFS. These results suggested the potential benefit of aggressive radiotherapy for patients with TKI treatment.
P066 - A Phase I Study of Apatinib Combined with Pemetrexed and Carboplatin in Untreated EGFR-Negative Stage IV Non-Squamous NSCLC (ID 81)
00:00 - 00:00 | Author(s): Y. Gong
This phase I study aimed to establish the feasible dose of Apatinib in combination with pemetrexed plus carboplatin as first-line therapy for EGFR-negative stage IV non-squamous non-small-cell lung cancer (NSCLC).
Using a 3+3 dose-reduction design, patients received oral Apatinib at four dose levels: 750 mg qd, 500 mg qd, 500 mg/day 2 weeks on/1 week off schedule (schedule 2/1) or 250mg qd. Pemetrexed (500 mg/m2) plus carboplatin (AUG=5) was administered every 3 weeks. The feasible dose was determined based on cycle 1 dose-limiting toxicities (DLT); other assessments included safety and antitumor activity according to response evaluation criteria in solid tumors.
A total of 12 patients were enrolled and cycle 1 DLTs were observed in two patients at 750 mg qd treatment (both Grade 3 hypertension), two patients at 500 mg qd (Grade 3 hypertension and Grade 3 hand-foot syndrome), and only one of six patients at 500 mg/day schedule 2/1 (Grade 3 hypertension). The most frequently drug-related adverse events were hematological toxicity, hypertension, hand-foot syndrome and hepatic transaminases elevation. Partial response was observed in 4 patients of 11 evaluable patients (ORR 36.4%), and 6 patients exhibited stable disease (DCR 90.9%).
In patients with advanced non-squamous NSCLC, the feasible dose of Apatinib given with standard-dose pemetrexed and carboplatin was 500 mg/day schedule 2/1. The schedule was generally well tolerated and demonstrated promising clinical benefit in NSCLC.