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Akihiro Tamiya



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    EP1.01 - Advanced NSCLC (ID 150)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.01-14 - The Scour Using Pretreatment NLR, Liver Metastasis, PD-L1 Status and PS as a Marker of Outcomes in Nivolumab-Treated Patients with Advanced NSCLC (Now Available) (ID 884)

      08:00 - 18:00  |  Presenting Author(s): Akihiro Tamiya

      • Abstract
      • Slides

      Background

      Although nivolumab showed the significantly longer overall survival (OS) compared with docetaxel for non-small cell lung cancer (NSCLC) based on two phase III randomized controlled trials, programed death ligand 1 (PD-L1) expression alone is not yet an adequate biomarker in treating nivolumab for NSCLC patients. Furthermore, some prior analyses indicated the liver metastasis, performance status (PS) and pretreatment neutrophil-to-lymphocyte ratio (NLR) is one of the candidates of effect predictors. This retrospective study aimed to analyze the score combining pretreatment patients’ status as a predictive marker in NSCLC patients treated with nivolumab.

      Method

      ne hundred and twenty-eight patients treated with Nivolumab who could examine the PD-L1 status from December 2015 to July 2016 were retrospectively reviewed. This study was multicenter study conducted by the three respiratory medical centers in Japan. We collected clinical data including age, sex, smoking history, histological types, PS, NLR, existence of Liver metastasis and PD-L1 status. We made the predictive score (PS2-4: 3 points, >NLR 4: 1 point, Liver metastasis +: 1 point, PD-L1 0%: 1 point and over 50%: -1 point) from pretreatment patients’ characteristics and evaluate the score (over 4 points is high risk group, 2-3 points is mediate risk group, and under 1 point is low risk group) as a marker of outcomes. The data cut off was on 31th October 2017.

      Result

      Median age was 67 years old, 86 patients were male, 101 patients had smoking history, 99 patients were PS 0-1 and 29 patients were PS 2-4, 26 patients were squamous carcinoma, >NLR 4 were 48 patients, and 16 patients had liver metastasis, respectively. Furthermore, PD-L1 expression 0% were 62 patients, 1-49% were 42 patients, and over 50% were 24 patients.

      Progression disease rate, median progression free survival (PFS) and median OS was 61.1%, 1.1 months, 2.4 months in high risk group; 60.6%, 1.4 months, 10.9 months in mediate risk group; and 36.4%, 4.6 months, 16.3 months in low risk group, respectively.

      Conclusion

      We could classify the three group which could predict an patients’ outcome according to the patients’ characteristics.

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    P2.01 - Advanced NSCLC (ID 159)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.01-60 - Analysis of Prognostic Factors According to Performance Status in Non-Small Cell Lung Cancer Patients Treated with Nivolumab (Now Available) (ID 739)

      10:15 - 18:15  |  Author(s): Akihiro Tamiya

      • Abstract
      • Slides

      Background

      Nivolumab has a promising efficacy for patients with non-small cell lung cancer (NSCLC) as second or later line treatment. Various prognostic factors have been reported in many articles. Among them, performance status (PS) is often reported as a strong prognostic factor. The aim of this study is to clarify the prognostic factors of good PS group and poor PS group.

      Method

      The medical records of 296 patients with NSCLC who were treated with nivolumab at Kinki-chuo Chest Medical Center between December 17, 2015 and December 31, 2018 were collected. We collected clinical data at the time of nivolumab treatment commencement. We investigated the relationship between progression free survival (PFS) and patient characteristics. Furthermore, we analyzed a prognostic value factor according to PS (PS 0-1 or PS 2-4).

      Result

      The median age was 70 (range, 40-90) years. 206 patients were male and 224 patients were good PS group (PS 0-1). The median PFS was 3.0 months, 4.6 months, 1.2 months in all patients, good PS group, poor PS group, respectively. Multivariate analysis showed smoking history correlated with longer PFS in both good PS group (Hazard ratio (HR), 0.452; 95% confidence interval (CI), 0.264-0.774; P = .00382) and poor PS group (HR, 0.248; 95% CI, 0.0946-0.6476; P = .00444). Furthermore, steroid use at baseline (HR, 2.341; 95% CI, 1.230-4.457; P = .00962), pleural effusion (HR, 1.516; 95% CI, 1.097-2.222; P = .01343), and liver metastases (HR, 1.732; 95% CI, 1.014-2.958; P = .00444) correlated with shorter PFS in good PS group. On the other hands, high level of advanced lung cancer inflammation index (ALI) (HR, 0.280; 95% CI, 0.109-0.724; P = .00861) and adenocarcinoma (HR, 0.464; 95% CI, 0.219-0.984; P = .0451) correlated with longer PFS in poor PS group.

      Conclusion

      Smoking history is independent predictors of nivolumab efficacy in both good PS group and poor PS group. Steroid use at baseline, pleural effusion, and liver metastases are independent prognostic factors in good PS group and ALI and histology are independent prognostic factors in poor PS group.

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