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Koichi Goto



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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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      181TiP - Phase II study of crizotinib in Japanese patients with advanced non-small cell lung cancer harboring a MET gene alteration: Co-MET study (ID 170)

      12:30 - 13:00  |  Author(s): Koichi Goto

      • Abstract

      Background

      The majority of non-small cell lung cancer (NSCLC) patients are diagnosed as metastatic disease for which no curative treatment is available. Phase III randomized trials of tyrosine kinase inhibitor (TKI) therapy for EGFR-mutant and anaplastic lymphoma receptor tyrosine kinase (ALK)-rearranged lung cancers have documented improvements in response and progression-free survival (PFS), and TKIs are approved for the treatment of patients with oncogene-driver mutations. c-Met is the tyrosine kinase receptor for hepatocyte growth factor, and MET gene alterations including MET exon14 skipping mutation-positive or MET high gene copy number are known to be an oncogene via activation of c-MET signaling pathway. Crizotinib is a selective ATP-competitive small-molecule inhibitor of c-Met, ALK and ROS1 tyrosine kinases. Durable responses to crizotinib were reported in patients with advanced NSCLC harboring MET exon 14 skipping mutation or high MET gene copy number. Therefore, we considered to assess the efficacy and safety of crizotinib in patients with advanced NSCLC harboring a MET gene alteration.

      a9ded1e5ce5d75814730bb4caaf49419 Trial design

      Co-MET is an open-label, multi-center, 2 cohort single-arm phase II trial of oral crizotinib in patients with advanced NSCLC harboring MET exon 14 skipping mutations without prior MET TKI treatment (cohort 1) or high MET gene copy number of 7 or more (cohort 2). The status of MET gene alterations will be determined using a validated RT-PCR assay and/or NGS. Crizotinib, 250 mg BID, will be administered orally continuously until disease progression or unacceptable toxicities. All tumor scans will be reviewed by an independent radiology committee according to RECIST version 1.1. The primary endpoint is objective response rate (ORR). Assuming a null hypothesis of a 20% ORR and an alternative hypothesis of a 50% ORR for cohort 1, and a one-sided type I error of 0.05 (one-side) and 80% power based on the exact binomial distribution, the required number of evaluable patients is 19. The sample size for cohort 2 is empirically set at 10 patients. Clinical trial information: UMIN000031623.

      d9b324a48b043b3d87bc9b3fe620f260 Clinical trial identification

      UMIN000031623.

      7a6a3ffa2dadc03a6151ee2c4d6fa383 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Japan Agency for Medical Research and Development.

      682889d0a1d3b50267a69346a750433d Disclosure

      K. Nosaki, S. Matsumoto: Honoraria: Pfizer Japan Inc. T. Seto: Honoraria, research grants: Pfizer Japan Inc. H. Murakami: Personal fees: Pfizer Japan Inc. K. Goto: Honoraria, research funding: Pfizer Japan Inc. K. Yoh: Research funding: Pfizer Japan Inc. All other authors have declared no conflicts of interest.

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      209P - Feasibility and utility of transbronchial cryobiopsy in primary lung cancer: Prospective, single arm study (ID 160)

      12:30 - 13:00  |  Author(s): Koichi Goto

      • Abstract

      Background

      Transbronchial forceps biopsy (FB) is the standard diagnostic tool for primary lung cancer. Recently, we need much amount of tissues for pathological diagnosis, mutational analysis and immunohistochemistry (IHC). The aim of this study was to prospectively evaluate safety, utility for diagnosis of primary lung cancer and biomarker analysis using cryoprobe, that was new transbronchial biopsy tool.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      A total of 128 patients with suspected of primary lung cancer were enrolled in this single arm trial and 121 patients were performed both transbronchial normal FB and transbronchial cryobiopsy (TBCB). We evaluated safety especially in bleeding and pneumothorax, diagnostic yield of malignancies, morphological diagnosis, size, tumor concentration of tissue samples and success rate of biomarker analysis.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Total diagnostic yield of TBCB was 92% (111/121), in details, 97% (62/64) in central bronchial lesions and 86% (49/57) in peropheral lung lesions. TBCB samples were more useful for morphological classification (86% vs. 79%), and larger size (median size was 15mm2vs. 2mm2, p < 0.001) than FB samples. The ratio of containing malignant cells in each FFPE samples were higher in TBCB (84% (148/177)) than in FB (73% (285/391)). TBCB was more useful for mutational analysis and PD-L1 IHC. Severe bleeding (need to sprinkle hemostatic) was observed each 1 case and grade 3 lung infection (need hospitalization and IV antibiotics) occurred in 4 patients (3%). There was no case of pneumothorax.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      TBCB is safe technique and useful for diagnosis of primary lung cancer. Furthermore, we could obtain more quantity and better quality of sample for diagnosis and biomarker analysis in comparison with conventional FB.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      National Cancer Center Hospital.

      213f68309caaa4ccc14d5f99789640ad Funding

      Japan Agency for Medical Research and development (15ck106111h0002).

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

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