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Ping Gu



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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 2
    • 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): Ping Gu

      • 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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      91P - Prognosis of EGFR-mutant advanced lung adenocarcinoma patients with different intrathoracic metastatic patterns (ID 273)

      12:30 - 13:00  |  Author(s): Ping Gu

      • Abstract
      • Slides

      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

      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.