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Jianlin Xu
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Lunch & Poster Display session (ID 58)
- Event: ELCC 2019
- Type: Poster Display session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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91P - Prognosis of EGFR-mutant advanced lung adenocarcinoma patients with different intrathoracic metastatic patterns (ID 273)
12:30 - 13:00 | Author(s): Jianlin Xu
- Abstract
Background
Lung cancer diagnosed solely with intrathoracic metastases are classified as M1a, but intrathoracic metastases can be further divided into different patterns. The objective of our study was to analyze the survival difference between different metastatic patterns of intrathoracic metastases in lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutations.
a9ded1e5ce5d75814730bb4caaf49419 Methods
EGFR-mutant patients diagnosed only with intrathoracic metastasis between March 2011 and October 2016 were collected. Prognosis was analyzed according to metastatic patterns based on univariate and multivariate analysis.
20c51b5f4e9aeb5334c90ff072e6f928 Results
A total of 137 patients (60 patients who only had pleural metastasis [Group A], 44 patients who only had contralateral lung metastasis [Group B] and other 33 patients had both pleural and contralateral lung metastasis with or without pericardial effusion [Group C]) were included in the study. The median OS (overall survival) times were 38.1(95%confidence interval [CI]: 27.8-48.4), 35.7(95%CI: 23.4-48.0), and 29.7(95%CI: 22.8-36.6) months for Group A, Group B, and Group C, respectively (p = 0.037). Multivariate analysis demonstrated that Group A and Group B had longer OS than Group C (hazard ratio [HR]=0.524, 95%CI: 0.307-0.894, p = 0.018; HR = 0.473, 95%CI: 0.241-0.931, p = 0.030, respectively) among lung adenocarcinoma patients with EGFR mutation. With regard to patients with pleural or contralateral metastasis only, OS benefit (p = 0.579) was not significant between the two groups. Subgroup analysis demonstrated that the OS benefit of Group A was significant in patients with N0-1 disease and 21L858R mutant but not in EGFR exon 19 deletion, N2-3 stage and T3-4 stage disease patients.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
The prognosis of EGFR-mutant lung adenocarcinoma patients diagnosed only with intrathoracic metastasis is different, indicating that M1a may should be refined in the future.
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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Mini Oral session II (ID 63)
- Event: ELCC 2019
- Type: Mini Oral session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 4/11/2019, 16:40 - 17:40, Room C
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117O - Racial disparities in characteristics and prognosis in Asian versus white patients receiving atezolizumab: An ancillary analysis of POPLAR and OAK studies (ID 339)
16:40 - 17:40 | Author(s): Jianlin Xu
- Abstract
- Presentation
Background
Racial differences in characteristics and prognosis of Asiatic and White patients receiving immunotherapy have not been well described.
a9ded1e5ce5d75814730bb4caaf49419 Methods
We studied 390 patients from the POPLAR and OAK studies who received atezolizumab with evaluable biomarker parameters retrieved from a subsequent blood-based study. The differences of Asians versus Whites in baseline characteristics, outcomes and genetic mutations of atezolizumab therapy were assessed.
20c51b5f4e9aeb5334c90ff072e6f928 Results
Asiatic and White patients differed in characteristics including smoking history, baseline sum of the longest diameters (BLSLD), EGFR mutation frequency, programmed death-ligand 1 (PD-L1) expression and blood-based tumor mutational burden (bTMB) level. Overall survival (OS) was longer in Asians compared with Whites before (median OS: 18.7 vs. 11.1 mo; P = 0.005) and after (median OS: 20.9 vs. 12.6 mo; P = 0.005) propensity score matching (PSM). Race was an independent prognostic factor for OS (Asian vs White: HR 0.647, 95% CI 0.447-0.936, P = 0.021) in addition to performance status (PS), histology, BLSLD, and number of metastatic sites. The objective response rate (ORR) for Asians and Whites was 8.2% and 17.1%, respectively and disease control rate (DCR) was 51.2% and 47.7%, respectively. The blood-based mutational landscape differentiated between Asians and Whites. In the overall population, mutations of STK11, EGFR, KEAP1, POLE, GRM3, ATM and STAG2 were associated with treatment response while mutations of TP53, KEAP1, APC, RB1, CREBBP, EPHA5 and STAG2 were associated with OS. Comparing the frequency of efficacy- or prognosis- related mutations, Asians had more EGFR mutations and less TP53 and STK11 mutations than Whites.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
Asians and Whites differed in the clinicopathological features and mutational landscape which may explain the superior efficacy of atezolizumab in Asiatic patients with NSCLC. This study conveys implications for further studies on racial disparity in the treatment of immunotherapy.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
The authors.
213f68309caaa4ccc14d5f99789640ad Funding
Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Support (No. 20161434).
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
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