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Yiming Zhao



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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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      142P - Clinical management of advanced lung adenocarcinoma with ALK rearrangement: Real-world treatment outcomes and long-term survival (ID 546)

      12:30 - 13:00  |  Author(s): Yiming Zhao

      • Abstract

      Background

      Anaplastic lymphoma kinase-tyrosine kinase inhibitors (ALK-TKIs) have been demonstrated to be effective in ALK-rearranged, advanced lung adenocarcinoma patients. However, data from a real-world setting is very limited. The aim of the study was to: a) determine long-term survival in these patients and investigate factors associated with their prognosis; and b) analyze the clinical outcomes of patients who were sequentially treated with next-generation ALK-TKIs.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      ALK-rearranged, advanced lung adenocarcinoma patients who were treated with crizotinib were included between January 2013 and December 2016. Progression-free survival (PFS) and overall survival (OS) were calculated by the Kaplan-Meier method. The hazard ratio (HR) for the risk of progression or death was calculated using multivariate Cox regression model.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      A total of 5286 patients were screened and 176 eligible patients were included. Median PFS and OS were 12.4 months (95% CI, 10.3-14.6 months) and 45.6 months (95% CI, 37.6-53.7 months), respectively. 36.3% of patients were 5-year survivors. Extrathoracic metastasis before crizotinib treatment was independently associated with worse PFS (HR, 1.77, 95% CI, 1.24-2.53, P < 0.01) and OS (HR, 1.61, 95% CI, 1.02-2.54, P = 0.04). 45 patients were sequentially treated with newer-generation ALK-TKIs, obtaining a statistically longer OS (54.8 months, 95% CI, not calculable) than patients who were solely treated with crizotinib during clinical management (36.6 months, 95% CI, 29.2-43.9 months, P < 0.01).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Our study provides useful information about ALK-rearranged, advanced lung adenocarcinoma patients treated with ALK-TKIs in a real-world setting.

      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

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      143P - Role of radiotherapy in management of brain metastases in anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC): A single-center retrospective study (ID 257)

      12:30 - 13:00  |  Presenting Author(s): Yiming Zhao

      • Abstract

      Background

      Targeted therapies provide benefits in ALK-rearranged patients with brain metastases (BM). However, role of radiotherapy in these patients hasn’t been established. This study sought to determine if upfront radiotherapy in combination with targeted therapies can impact patient outcomes.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      A total of 60 ALK-rearranged patients with BM were included for analysis. 34 patients developed BM prior to TKIs: 20 patients received radiotherapy followed by crizotinib and 14 received upfront crizotinib. 26 patients developed BM while receiving crizotinib: 13 patients were treated with crizotinib beyond progression after brain radiotherapy and 13 received next-generation TKIs with or without radiotherapy. Overall survival (OS) and intracranial time to progression (IC-TTP) were calculated from the date of BM.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Among patients with BM prior to TKIs, upfront radiotherapy cohort had longer IC-TTP (22.9 vs 8.9 months; p = 0.022) and longer OS (28.6 vs 23.3; p = 0.024) compared to upfront crizotinib cohort. Of patients who developed BM while receiving crizotinib, continuation of crizotinib plus radiotherapy for those without extracranial progression can give another intracranial progression-free time. However, next-generation TKIs cohort showed superior median IC-TTP compared to crizotinib beyond progression (11.4 vs 7.2 months; p = 0.006). Patients treated with radiotherapy followed by second TKIs even had much longer IC-TTP (21.8 vs 7.2 months; p = 0.009), though median IC-TTP of second TKIs without radiotherapy failed to reach statistical significance compared with crizotinib beyond progression (10.4 vs 7.2 months; p = 0.1).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Upfront radiotherapy provided better outcomes for ALK-positive patients who developed BM before TKIs and during treatment of crizotinib, and should be considered.

      b651e8a99c4375feb982b7c2cad376e9 Editorial acknowledgement

      We would like to acknowledge all the patients and their families for their contributions to this study.

      934ce5ff971f1ab29e840a35e3ca96e9 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

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

      12:30 - 13:00  |  Author(s): Yiming Zhao

      • 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