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Suresh Senan
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Challenges in clinical oncology: YO case discussions (ID 14)
- Event: ELCC 2019
- Type: Educational session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 4/11/2019, 09:00 - 10:30, Room C
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Mentor guided discussion (ID 613)
09:00 - 10:30 | Presenting Author(s): Suresh Senan
- Abstract
- Presentation
Abstract not provided
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Current role and future of thoracic radiotherapy (ID 17)
- Event: ELCC 2019
- Type: Specialty session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 4/11/2019, 11:00 - 12:30, Room C
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Synchronous and metachronous primary tumours (ID 46)
11:00 - 12:30 | Presenting Author(s): Suresh Senan
- Abstract
- Presentation
Abstract not provided
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Lunch & Poster Display session (ID 58)
- Event: ELCC 2019
- Type: Poster Display session
- Track:
- Presentations: 4
- Moderators:
- Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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185TiP - RATIONALE 001: Tislelizumab (BGB-A317) + concurrent chemoradiotherapy (cCRT) followed by tislelizumab monotherapy in patients (pts) with newly diagnosed locally advanced, unresectable, stage III non-small cell lung cancer (NSCLC) (ID 252)
12:30 - 13:00 | Author(s): Suresh Senan
- Abstract
Background
In pts with locally advanced, unresectable, stage III NSCLC, cCRT is associated with better survival than radiotherapy (RT) alone, but 5-y survival remains poor. Immunotherapies targeting PD-1/PD-L1 may be synergistic with cCRT, improving outcomes. Tislelizumab, an anti–PD-1 antibody, showed clinical activity/tolerability in solid tumors, including NSCLC. RATIONALE 001 is a phase III, randomized, double-blind, placebo-controlled trial evaluating the efficacy and safety of first-line tislelizumab + cCRT in pts with locally advanced, unresectable, stage III NSCLC.
a9ded1e5ce5d75814730bb4caaf49419 Trial design
RATIONALE 001 aims to answer important scientific questions by employing a 3-arm study design (840 pts randomized 1:1:1) to evaluate whether the timing of giving tislelizumab earlier upfront with cCRT in addition to consolidation will improve outcomes rather than giving the anti–PD-1 as consolidation only (Table). Both tislelizumab approaches (Arms 1 and 2) will each be compared to a global standard of care, cCRT alone. Chemotherapy will be investigator’s choice (cisplatin + etoposide or carboplatin + paclitaxel). RT will be given in 2 Gy fractions (target dose of 60 Gy). Key eligibility: Locally advanced, unresectable, stage III NSCLC; stage III confirmed by FDG-PET and brain imaging; Eastern Cooperative Oncology Group performance status ≤ 1; and no prior anti–PD-1/PD-L1 therapy. PD-L1 expression assessment is not required prior to randomization. Primary endpoint: Progression-free survival. Secondary endpoints include overall survival (OS), OS at 24 mo, objective response rate, and safety. Blood and tumor biomarkers, including PD-L1 expression and tumor mutational burden, will be evaluated for correlations with clinical benefit.
d9b324a48b043b3d87bc9b3fe620f260 Clinical trial identification
NCT03745222; EudraCT: 2018-001132-22.
7a6a3ffa2dadc03a6151ee2c4d6fa383 Legal entity responsible for the study
Celgene Corporation.
213f68309caaa4ccc14d5f99789640ad Funding
Celgene Corporation.
682889d0a1d3b50267a69346a750433d Disclosure
L. Paz-Ares: Honoraria: Lilly, MSD, BMS, Roche, Pharmamar, Merck, AstraZeneca, Novartis, Boehringer Ingelheim, Celgene, Servier, Sysmex, Celgene, Amgen, Incyte, Pfizer; Board member: Genomica; Institutional financial interest: AstraZeneca, BMS, MSD. S. Senan: Grants/Research support: Varian Medical Systems; Advisory/Board member: Celgene, AstraZeneca; Honoraria: Varian Medical Systems, AstraZeneca. D. Planchard: Consulting, honoraria, travel and/or institutional: AZ, BMS, BI, Celgene, Daiichi Sankyo, Eli Lilly, Merck, MedImmune, Novartis, Pfizer, prIME Onc, Peer CME, Roche; Institutional: Medimmune, Sanofi-Aventis, Taiho Pharma, Novocure, Daiichi Sankyo. A. Cheong: Employment, stock holder: Celgene Europe Ltd. R. Slepetis: Employment, stock holder: Celgene. M.H. Nguyen: Employment, stock holder: Celgene Corporation. E.E. Vokes: Employment: University of Chicago; Grants/Research support: AbbVie; Consultant, honoraria: AbbVie, Amgen, AstraZeneca, Biolumina, BMS, Celgene, Eli Lilly, EMD Serono, Genentech, Merck, Novartis, Regeneron. All other authors have declared no conflicts of interest.
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58P - Evaluation of a care path for patients with lung tumors and co-existing interstitial lung disease (ID 300)
12:30 - 13:00 | Author(s): Suresh Senan
- Abstract
Background
Patients with lung cancer and co-existing interstitial lung disease (ILD) are at increased risk of treatment-related toxicity after both surgery and radiotherapy. A care path was implemented at our institution for patients presenting to the lung tumor board with a possible ILD, and we report on our experience using this structured approach.
a9ded1e5ce5d75814730bb4caaf49419 Methods
Since 2015, patients with possible lung cancer and ILD were referred to the general ILD clinic for assessment. In 2017, a dedicated ILD lung tumor board was established in order to facilitate quick assessment of treatment-related risks. An ethics-approved institutional database containing details of all these patients was accessed.
20c51b5f4e9aeb5334c90ff072e6f928 Results
24 patients with lung tumors and a co-existing ILD were identified (
fd69c5cf902969e6fb71d043085ddee6 ConclusionsTable ). The mean interval between referral to, and consultation at our ILD-board was 2 weeks. A prior diagnosis of ILD was available in 9 of 17 (53%) patients, but review led to a re-classification of the ILD subtype in 8 of the former. Treatments for lung cancer included radiotherapy alone (n = 14), surgery (n = 6), sequential chemoradiation (n = 3), and concurrent CRT followed by salvage surgery (n = 1). 6 patients developed progression of ILD after radiation; of these, 2 had received nintedanib during treatment. One patient died because of progressive ILD and in another 3 patients ILD-related deaths could not be excluded.
A dedicated care path for ILD patients resulted in a fast evaluation of lung cancer patients. A previous ILD-diagnosis was revised in a majority of patients, a process which can allow for a better understanding of treatment-related risks in different subgroups of ILD patients, and also assess the role of ILD-directed therapies.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
The authors.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
S. Senan: Grants, during the conduct of the study: ViewRay Inc.; Personal fees, outside the submitted work: Varian Medical Systems. All other authors have declared no conflicts of interest.
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67TiP - ADRIATIC: A phase III trial of durvalumab ± tremelimumab after concurrent chemoradiation for patients with limited stage small cell lung cancer (ID 237)
12:30 - 13:00 | Presenting Author(s): Suresh Senan
- Abstract
Background
Limited stage small-cell lung cancer (LS-SCLC), which represents ∼30% of newly diagnosed SCLC, remains an area of high unmet medical need. Standard of care, which has not changed for several decades, consists of curative intent platinum-based chemotherapy concurrent with radiotherapy (cCRT) followed by prophylactic brain irradiation (PCI) and observation. Despite good response to cCRT, outcomes remain poor, with median progression-free survival (PFS) ∼15 months and overall survival (OS) ∼25 months. Durvalumab (D) is a selective, high-affinity, human IgG1 monoclonal antibody (mAb) that blocks programmed cell death ligand-1 binding to programmed cell death-1 and CD80. Tremelimumab (T) is a selective human IgG2 mAb against CTLA-4. D demonstrated a PFS and OS advantage over placebo in locally advanced NSCLC following cCRT. D and D + T demonstrated a tolerable safety profile and antitumour activity in pretreated extensive stage SCLC. The ADRIATIC trial (NCT03703297) will assess if treatment with D ± T is beneficial vs placebo in patients (pts) with LS-SCLC who have not progressed following cCRT.
a9ded1e5ce5d75814730bb4caaf49419 Trial design
ADRIATIC is a Phase 3, randomised, double-blind, multicentre, placebo-controlled international trial. Pts (N∼600) will be randomised 1:1:1 to receive D + placebo T, D + T, or dual placebo, stratified by Stage (I/II vs III) and receipt of PCI at the investigator’s discretion (yes vs no). Eligible pts must have confirmed inoperable Stage I–III LS-SCLC; WHO/ECOG PS 0/1; and completed 4 cycles of cCRT with a response of stable disease or better within 1–42 days prior to randomisation. Pts will receive the assigned treatment until clinical, RECIST v1.1-defined progressive disease, intolerable toxicity or for a maximum of 24 months, whichever comes first. Primary objectives are PFS and OS for D ± T vs placebo. Key secondary endpoints include health-related quality of life, and safety and tolerability. Recruitment is ongoing
d9b324a48b043b3d87bc9b3fe620f260 Clinical trial identificationArm Dose Initial regimen (first 4 cycles) Continuation regimen (up to 24 months) D + placebo T D = 1500 mg (intravenous [i.v.]) D + placebo T q4w D q4w alone after the final dose of D + placebo T D + T combination D = 1500 mg (i.v.)T = 75 mg (i.v.) D + T q4w D q4w alone after the final dose of D + T Placebo D + placebo T i.v. saline Placebo D + placebo T q4w Placebo D q4w
NCT03703297.
7a6a3ffa2dadc03a6151ee2c4d6fa383 Editorial acknowledgement
Medical writing support, which was in accordance with Good Publication Practice (GPP3) guidelines, was provided by Craig Turner, MSc, of Cirrus Communications, an Ashfield company (Macclesfield, UK), and was funded by AstraZeneca.
934ce5ff971f1ab29e840a35e3ca96e9 Legal entity responsible for the study
AstraZeneca PLC.
213f68309caaa4ccc14d5f99789640ad Funding
AstraZeneca.
682889d0a1d3b50267a69346a750433d Disclosure
S. Senan: Departmental research grant: AstraZeneca, Varian Medical Systems, ViewRay Inc.; Advisory boards: AstraZeneca, MSD, Eli Lilly, Celgene. N. Shire: Employment, stock: AstraZeneca, outside the submitted work. G. Mak W. Yao, H. Jiang: Employment, stock: AstraZeneca, outside the conduct of the study.
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73P - Utilization rates of stereotactic body radiation therapy for the treatment of stage I NSCLC in three European countries (ID 445)
12:30 - 13:00 | Author(s): Suresh Senan
- Abstract
Background
Stereotactic body radiation therapy (SBRT) has become increasingly accepted as a treatment for patients with inoperable early stage lung cancer. We studied the patterns of treatment utilization for stage I non-small cell lung cancer (NSCLC) in three European countries in patients diagnosed in 2015-2016.
a9ded1e5ce5d75814730bb4caaf49419 Methods
Information from population-based registries in England, Norway and the Netherlands were retrieved, and treatment patterns and two-year survival for patients with clinical stage I were analysed.
20c51b5f4e9aeb5334c90ff072e6f928 Results
Resection rates were higher in Norway (55%) and England (53%) than in the Netherlands (47%). SBRT use was highest in the Netherlands (41%), followed by Norway (29%) and England (12%). Failure to perform curative intent treatment was more common in England (26%) than either Norway (13%) or the Netherlands (9%). In patients treated with SBRT, pathology confirmation of diagnosis was more common in Norway (70-73%) than in England (44-51%) or the Netherlands (47-50%). Two-year survival rates were better for surgery than for SBRT or conventional radiotherapy and treatment-specific survival was higher in Norway than in the other two countries.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
For clinical stage I NSCLC, SBRT has largely replaced conventional radiotherapy in both Norway and the Netherlands, while just 67% of radiotherapy patients in England receive SBRT. The proportion of patients not receiving any curative treatment was higher in England, especially in the elderly.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
The authors.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
S. Senan: Research grants: Varian Medical Systems, ViewRayInc; Membership of advisory boards: AstraZeneca, MSD. All other authors have declared no conflicts of interest.
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