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Yinchen Shen



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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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      131P - Upfront whole brain radiotherapy for multiple brain metastases in patients with EGFR-mutant lung adenocarcinoma (ID 268)

      12:30 - 13:00  |  Author(s): Yinchen Shen

      • 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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      149P - Efficacy of tyrosine kinase inhibitors (TKIs) in advanced lung adenosquamous carcinoma (ID 291)

      12:30 - 13:00  |  Author(s): Yinchen Shen

      • Abstract

      Background

      Adenosquamous carcinoma (ASC) is a rare type of lung cancers, with components of both squamous carcinoma and adenocarcinoma comprising to at least 10% of the tumor. EGFR-TKIs are playing an increasingly important role in the treatment of mutation-positive lung adenocarcinoma. However, the frequency and efficacy of multi-line EGFR-TKIs for ASC patients with sensitive EGFR mutations remain unclear.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      From January 2010 to January 2018, patients pathologically diagnosed as lung ASC in Shanghai Chest Hospital were screened. The effectiveness of EGFR-TKIs in advanced ASC patients with EGFR mutation is retrospectively analyzed.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      A total of 268 ASC patients were screened and 189 patients were tested for the presence of EGFR mutation. 101 positive patients were identified (53.0%, 95% CI, 46.3-60.6%), of which there are 43 19del, 44 21L858R mutations, 6 compound mutations or rare mutations, the rest lack of specific information. A higher frequency of EGFR mutation was found in younger, female patients who were non-smokers. We retrospectively collected consecutive survival data of 67 advanced ACS patients with EGFR-TKI therapy of different generations. Forty-six (46/52, 88.5%) patients had disease progression after first-generation EGFR-TKI treatment, with a median progression free survival (PFS) of 10.7 months (95% CI, 8.6-12.8 months) and a median duration of treatment (MDT) of 13.1 months (95% CI, 8.4-17.8 months). Median PFS for 15 eligible patients received third-generation TKI treatment was 10.2 months (95% CI, 8.3-12.1 months). Median overall survival (OS) for 14 eligible patients with multi-line EGFR-TKIs treatment was 42.1 months (95% CI, 15.7-68.5 months), compared to median OS of patients without third-generation treatment (25.1 months, 95% CI, 10.7-39.4) months.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Our data suggests the detection of EGFR mutations in patients with ASC, especially in young, female, non-smoking patients. The third-generation EGFR-TKI treatment could be a better choice to improve outcomes of advanced patients after progression of first-generation TKI.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      Minjuan Hu.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      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): Yinchen Shen

      • 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

      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.

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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): Yinchen Shen

      • 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.