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Seung Hun Jang
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MA16 - Prioritizing Use of Technology to Improve Survival of Lung Cancer Subgroups and Outcomes with Chemotherapy and Surgery (ID 142)
- Event: WCLC 2019
- Type: Mini Oral Session
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:Jair Bar, Navneet Singh
- Coordinates: 9/09/2019, 15:45 - 17:15, Interlaken (1988)
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MA16.10 - Antioxidative Effect of Erdosteine on Platinum-Based Doublet Chemotherapy Induced Nephrotoxicity (Now Available) (ID 1080)
15:45 - 17:15 | Author(s): Seung Hun Jang
- Abstract
- Presentation
Background
Many classes of antineoplastic agents including the platinum coordination complexes are also known to generate free radicals which have a role in the side effects of chemotherapy. Despite the introduction of new treatments including target and immunotherapy, platinum-based doublet chemotherapy is one of the most widely used and most potent chemotherapy drugs to treat lung cancer patients especially with small cell lung cancer. However, side effects in normal tissues and organs, notably nephrotoxicity in the kidneys, limit the use of platinum-based doublet chemotherapy. There are several experimental evidences which support the protective effect of erdosteine in acute injury induced by a variety of pharmacological or noxious agents, mediated by products of oxidative stress. Erdosteine is a multifactorial drug currently used in lung disease. In the last decade, data from several studies to the possible antitussive and anti-inflammatory properties of erdosteine and an indirect anti-inflammatory mechanism of action related to the ROS scavenging activity was suggested. The purpose of this study is to investigate whether erdostein can reduce the renal toxicity of lung cancer with platinum-based doublet chemotherapy by antioxidant role.
Method
This study was a prospective, randomized, double-blind clinical trial on 153 patients with lung cancer(small cell lung cancer and non-small cell lung cancer). Patients who was treated with platinum-based doublet chemotherapy were randomly assigned into 2 groups of intervention(erdostein) group and control(non-erdostein) subjects regardless of the type of lung cancer. Intervention group took erdosteine 600 mg orally twice a day. We measured CCr, serum/urine NGAL, serum/urine Cystatin C, urine KIM-1 of the lung cancer patients who underwent platinum-based doublet chemotherapy to assess renal injury. And also we measured the activity of specific antioxidant enzymes, such as catalase and superoxide dismutase to evaluate oxidative stress. Serum and urine samples were collected from the patient before and after chemotherapy.
Result
There was no significant difference of renal status between intervention and control groups at baseline. However, Statistically there was a significant decline in CCr among control group regardless of the type of lung cancer and the resimen of chemotherapy. NGAL expression of blood and urine was decreased in intervention group (especially patient treated with cisplatin and small cell lung carcer patients) but Cystatin C levels showed no difference between two groups. The decrease in urinary KIM-1 after cisplatin-based doublet chemotherapy in intervention group were observed compared to control group. Superoxide dismutase levels of serum were approximately increased to twice the initial level to the level measured after chemotherapy in the treatment group while the level of catalase did not change significantly in both the groups.
Conclusion
These results show that erdosteine may be a promising drug for protection against platinum-based doublet chemotherapy-induced nephrotoxicity, especially for patients with cisplatin-based doublet chemotherapy and small cell lung cancer. However, further studies with different dose of erdosteine are warranted for clarifying the issue.
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P1.11 - Screening and Early Detection (ID 177)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.11-18 - The Results of Mandatory Smoking Cessation Intervention in a Population-Based Lung Cancer Screening Trial (ID 1489)
09:45 - 18:00 | Author(s): Seung Hun Jang
- Abstract
Background
A large strand of research supports the idea of implementing a population-based lung cancer screening program using low-dose computer tomography to reduce lung cancer mortality. It has been recognized that one of the key factors contributing a successful lung screening program is its combination with smoking cessation intervention. This study provides results of smoking cessation intervention in a population-based lung cancer screening trial.
Method
Korean Lung Cancer Screening Project (K-LUCAS) is a single arm prospective nationwide lung cancer screening trial. In K-LUCAS, all currently smoking participants were provided with mandatory smoking cessation counselling. Smoking status of 5,144 currently smoking participants in K-LUCAS were surveyed by telephone 6 months after participation. There were some variations in the intervention; the department of which counselling is provided within; publically or privately operated smoking clinics; and whether or not counselling is provided simultaneously with screening results. The impact of such variations on smoking cessation is also reported.
Result
Participant’s motivation to quit smoking increased by 9.4% on average after participating in lung cancer screening. The smoking cessation rate was 24.7% and over 80% of quitters said that participation in lung cancer screening motivated them to quit smoking. The smoking cessation counselling was more effective when the smoking clinics are operated by national health insurance services than when operated privately by hospital and when counselling was provided simultaneously with screening results than when provided separately with screening results. The screening results itself also affected smoking cessation. The probability of quitting smoking for participants with positive screening results were significantly higher than participants with negative results.
Conclusion
Smoking cessation intervention combined with lung cancer screening program encourages smoking cessation for screening participants. Our results the highlights the importance of incorporating smoking cessation intervention in lung cancer screening program which would further enhance the effectiveness of lung cancer screening program.
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P2.14 - Targeted Therapy (ID 183)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Targeted Therapy
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.14-03 - Predictive Factors of Osimertinib as Salvage Treatment for Metastatic EGFR T790M Positive Lung Adenocarcinoma (Now Available) (ID 1716)
10:15 - 18:15 | Presenting Author(s): Seung Hun Jang
- Abstract
Background
EGFR T790M mutation is a robust biomarker for the efficacy of osimertinib. But its clinical efficacy is very limited in a part of patients with non-small cell lung cancer harboring EGFR T790M mutation, suggesting primary resistance. The purpose of this study was to discover clinical predictive factors for the efficacy of osimertinib
Method
This retrospective study analyzed patients with stage IV, EGFR T790M positive lung adenocarcinoma given osimertinib as salvage treatment. Various baseline clinical factors were investigated according to favorable or unfavorable osimertinib efficacy group. Unfavorable efficacy (primary resistant) group was defined as progression-free survival (PFS) < 6 months with osimertinib.
Result
Thirty patients were eligible for this analysis (19 of favorable and 11 of unfavorable efficacy group). PFS of favorable and unfavorable efficacy group with osimertinib were 9.9 months (95% CI 9.5-10.3) and 3.3 months (95% CI 2.4-4.2), respectively (p<0.001). Response rate of osimertinib was 89.5% vs. 18.2% (p<0.001). The cases with age at the time of lung cancer diagnosis ≥ 60 years, baseline (before starting osimertinib) Neutrophil to Lymphocyte Ratio (NLR) ≤ 3.5, pre-osimertinib treatment with first generation EGFR-TKI (gefintinib or erlotinib) rather than second generation EGFR-TKI (afatinib) were more frequent in the favorable efficacy group (p=0.058, 0.058, and 0.088, respectively, chi-square test). Age at the time of lung cancer diagnosis, ECOG performance, baseline NLR, pre-osimertinib EGFR-TKI generation, and PFS with previous EGFR-TKI were revealed as potential predictive factors through Kaplan-Meier PFS estimation. Finally, Cox proportional hazard regression analysis confirmed age at the time of lung cancer diagnosis ≥ 60 years (HR 0.292, 95% CI 0.104-0.819, p=0.019) and baseline NLR ≤ 3.5 (HR 0.238, 95% CI 0.083-0.677, p=0.007) were good predictive factors for the efficacy of osimertinib
Conclusion
Relatively old age and low neutrophilic inflammation were associated with favorable efficacy of osimertinib.
