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Fang Hu



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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 3
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      131P - Upfront whole brain radiotherapy for multiple brain metastases in patients with EGFR-mutant lung adenocarcinoma (ID 268)

      12:30 - 13:00  |  Author(s): Fang Hu

      • Abstract
      • Slides

      Background

      This study aimed to evaluate the efficacy of upfront whole-brain radiotherapy (WBRT) in epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma with multiple brain metastases (BM).

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      195 patients with EGFR mutations who had multiple BM at preliminary diagnosis were included and retrospectively reviewed in this study. Patients were administered for following treatments in a multi-disciplinary setting: upfront WBRT followed by EGFR-TKI, concurrent EGFR-TKI and WBRT and upfront EGFR-TKI followed by WBRT. A disease specific graded prognostic assessment (GPA) was performed for all the patients. The treatment response and overall survival (OS) were evaluated.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      The median OS of these patients was 27 months. Objective response rate (ORR) was much better in upfront WBRT group than other two groups (P = 0.004). Moreover, patients receiving upfront WBRT (n = 67) had longer OS than the concomitant group (36 vs. 25 months; P = 0.006) and the upfront EGFR-TKI group (36 vs. 25 months; P < 0.0001). The prognosis of patients with different GPA scores significantly differed (p < 0.0001). In subgroup of concomitant and upfront EGFR-TKI groups, patients with higher GPA scores (2-3) had more favorable prognosis compared with those with lower scores (0-1.5) (27 versus 25 months; P = 0.023). Patients receiving EGFR-TKI concurrently with WBRT had superior OS than those receiving upfront EGFR-TKI with high GPA scores. (37 versus 17 months; P = 0.023).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      The use of upfront WBRT in EGFR-mutated lung adenocarcinoma patients with multiple BM improves ORR and OS. More importantly, patients with high GPA scores are recommended to receive WBRT soon after EGFR-TKI therapy.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      National Natural Science Foundation of China (No.81502450) and Science and Technology Commission of Shanghai Municipality, China (No.18441904700).

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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      190P - ERGR-TKIs combined with chemotherapy delays intracranial progression in EGFR-mutant lung adenocarcinoma patients (ID 269)

      12:30 - 13:00  |  Author(s): Fang Hu

      • Abstract
      • Slides

      Background

      The aim of this study was to evaluate if the combination of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) plus chemotherapy could delay the presence and decrease the incidence of brain metastases (BM) in patients with EGFR-mutant advanced lung adenocarcinoma.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      100 eligible patients who developed BM were retrospectively reviewed. Patients received treatment with either EGFR-TKI monotherapy or EGFR-TKI plus chemotherapy. Intracranial progression-free survival (iPFS), systemic progression-free survival (PFS) and overall survival (OS) were evaluated.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      The median OS in the whole group was 37 months (interquartile range 6 to 94 months). Patients treated with EGFR-TKI plus chemotherapy had longer PFS compared with EGFR-TKI alone (16 vs. 10 months; P=0.030). Moreover, addition of chemotherapy showed an obvious iPFS advantage over EGFR-TKI alone (21 vs. 14 months; P=0.026). In all initial progression, less patients in the combination group developed BM compared to patients treated with EGFR-TKI monotherapy (15 vs. 27, P=0.002), with a hazard ratio (HR) of 0.64 (95% CI, 0.43−0.96) for BM in the combination group versus the EGFR-TKI monotherapy group.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      The combination of EGFR-TKI plus chemotherapy demonstrated prolonged iPFS as well as PFS and reduced the occurrence and progression risk of intracranial metastases compared to EGFR-TKI monotherapy. EGFR-TKI plus chemotherapy is recommended for lung adenocarcinoma patients with EGFR-sensitive mutations.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Science and Technology Commission of Shanghai Municipality, China (No.18441904700).

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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      35P - Clinicopathological characteristics with genetic profiling and prognostic analysis of primary lymphoepithelioma-like carcinoma in Chinese south-eastern population (ID 275)

      12:30 - 13:00  |  Author(s): Fang Hu

      • Abstract
      • Slides

      Background

      Primary lymphoepithelioma-like carcinoma (LELC) is a rare form of lung cancer, since genetic alternations participate in the carcinogenesis in lung cancer, whether critical driver genes such as ROS1 fusion, anaplastic lymphoma kinase (ALK) rearrangement and epidermal growth factor receptor (EGFR) mutation play roles in LELC remains unclear.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      We collected a total of 30 LELC samples for genetic and prognosis analysis retrospectively in ShangHai Chest Hospital, EGFR gene mutation, ALK rearrangement and ROS1 fusion status were extracted from digital database. Clinicopathological characteristics with genetic profiling and survival were analyzed.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      All samples appeared negative for genes (EGFR, ALK and ROS1) alternations detection. Female gender acted as an independently prognostic factor in poorer disease-free survival (DFS) (P = 0.034), and tumors locate in the left lobe associate with worse DFS in univariate analysis (significant trend, P = 0.051), moreover, serum positive NSE level also indicate a shorter DFS after adjustment (significant trend, P = 0.057). Most of LELC are diagnosed at early stage, with 93.3% (27/30) patients obtained the opportunities for surgery.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Since no classical genetic alternations appeared in present study, more investigations of other genes distributions should be explored in the future for better understanding of this rare subtype of lung cancer. Serum positive NSE level seemed to be a prognostic biomarker for DFS in LELC patients.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.