Virtual Library
Start Your Search
Satoshi Igawa
Author of
-
+
EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
-
+
EP1.01-68 - Impact of EGFR Genotype on the Efficacy of Osimertinib in Patients with Non-Small Cell Lung Cancer: A Prospective Observational Study (ID 271)
08:00 - 18:00 | Presenting Author(s): Satoshi Igawa
- Abstract
Background
A T790M of the epidermal growth factor receptor (EGFR) is the most frequently encountered mutation occurring acquired resistance to EGFR tyrosine kinase inhibitors (TKIs) in non-small cell lung cancer (NSCLC). The aim of this study was to assess the differential clinical outcomes of osimertinib therapy in NSCLC patients with T790M according to the type of active EGFR mutation, i.e. exon 19 deletion or L858R point mutation.
Method
We conducted a prospective observational cohort study to evaluate the efficacy and safety of osimertinib in patients with major EGFR mutation and T790M-positive advanced NSCLC who had disease progression after first-line EGFR-TKI therapy. The efficacy of osimertinib was evaluated according to the type of EGFR mutation.
Result
A total of 51 patients were included in this study. The exon 19 deletion was found in 33 (65%) patients, and the L858R point mutation in 18 patients (35%). An objective response was obtained in 29 patients, indicating an objective response rate of 58.8%. The response rate was 69.7% in patients with exon 19 deletion and 38.9% in patients with L858R point mutation, indicating a statistically significant difference (P =0.033). The median progression-free survival (PFS) and overall survival (OS) of the entire patient population were 7.8 and 15.5 months, respectively. Median PFS in the exon 19 deletion and L858R point mutation groups was 8.0 months and 5.2 months, respectively, indicating a statistically significant difference (P =0.045). Median OS in the exon 19 deletion and L858R point mutation groups was 19.8 months and 12.9 months, respectively, indicating a statistically significant difference (P =0.0015). Multivariate analysis identified exon 19 deletion as a favorable independent predictor of PFS and OS.
Conclusion
Investigators should consider the proportions of sensitive EGFR mutation types as a stratification factor in designing or reviewing clinical studies involving osimertinib.
-
+
EP1.12 - Small Cell Lung Cancer/NET (ID 202)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Small Cell Lung Cancer/NET
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
-
+
EP1.12-36 - Treatment Outcomes and Risk Factors of Limited-Stage Small Cell Lung Cancer Patients Treated with Chemoradiotherapy (Now Available) (ID 442)
08:00 - 18:00 | Author(s): Satoshi Igawa
- Abstract
Background
The aim of this study was to report clinical outcomes and prognostic factors in limited- stage small cell lung cancer (LD-SCLC) patients treated with chemoradiotherapy (CRT).
Method
Data on 107 LD-SCLC patients who received CRT between September 2000 and March 2017 were analyzed retrospectively. The median age of the patients was 66 years (range 42–85 years); 79 (73.8%) patients were male and 28 (26.2%) were female. Seventy-four (69.2%) patients received concurrent CRT (CCRT) with 45 Gy in 30 twice-daily fractions (n=52) or with 54–60 Gy in 27–30 once-daily fractions (n=22). The other 33 patients received sequential CRT (SCRT) with 54–60 Gy in 27–30 once-daily fractions. Prophylactic cranial irradiation was administered to 35 (32.7%) patients. Cisplatin/etoposide or carboplatin/etoposide were mainly selected as chemotherapy regimens. Survival rates were estimated using the Kaplan-Meier method, and univariate and multivariate analysis was performed using the log-rank test and Cox proportional hazard model, respectively.
Result
Median follow-up duration was for 28.6 months (range 1.6–147.2 months). Three-year overall survival, progression-free survival and cause-specific survival rates were 51.1%, 38.8% and 51.5%, respectively.
On univariate analysis metastatic lymph node status (N0 vs N≥1) and timing of CRT (CCRT vs SCRT) were detected as significant prognostic factors for overall survival (3-year overall survival: 100% vs 48.2%, p=0.02; and 56.6% vs 37.7%, p=0.04, respectively). On multivariate analysis, however, these factors did not reach statistical significance.
Conclusion
Treatment outcomes in LD-SCLC patients suggested metastatic lymph node status and timing of CRT as prognostic factors for overall survival.
-
+
P1.14 - Targeted Therapy (ID 182)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
-
+
P1.14-36 - Phase II Trial of Afatinib in Elderly Patients Aged Over 75 Years with EGFR Mutation Positive Non-Small Cell Lung Cancer (ID 970)
09:45 - 18:00 | Author(s): Satoshi Igawa
- Abstract
Background
Although reports on the use of gefitinib or erlotinib in elderly patients were occasionally found, those on afatinib were rare. According to the analysis of 54 Japanese patients in the LUX-Lung3 study, the dose reduction of afatinib from 40 mg/day was necessary for 76.0% of patients. However, the prolonged administration was possible after a dose reduction to 30 or 20 mg/day, and antitumor effects were maintained with the reduced dose.
Method
The efficacy and safety of afatinib at 30 mg/day in PS 0-1 patients who were aged 75 years with EGFR mutation positive chemotherapy-naïve non-small cell lung cancer were studied. The primary endpoint was the response rate (RR), and the planned number of registered cases was set at 35, with a threshold RR of 50%, an expected RR of 75%, α of 0.05, and β of 0.1. The secondary endpoints were progression-free survival (PFS), overall survival (OS), the incidence rate of adverse events (AEs), QOL survey (FACT-L), and trough plasma concentration of afatinib at steady state (PK, collected between the 8th to 15th day after the start of oral administration).
Result
The data of 35 patients were collected from May 2015 to August 2017. Patient background was, median age of 79 years (75-92), male/female: 8/27, PS 0/1: 8/27, adenocarcinoma/NSCLC: 30/5, IIIA/IIIB/IV/postoperative recurrence (TNM 7th edition): 2/2/22/9, and exon19del/exon21L858R/exon19del+exon21L858R: 15/19/1. The best overall efficacy was PR/SD/PD/NE: 28/4/1/2, and the RR was 80.0% (95% CI, 63.1-91.6). The median PFS and OS were 16.3 months (95% CI, 11.8-27.0) and not reached, respectively. The main AEs were rash 69%, diarrhea 60%, and paronychia 51%. While the initial afatinib dose was 30 mg, nine (26%) patients continued with 30 mg, 23 (66%) were reduced to 20 mg, and 3 (8%) discontinued due to AEs (2 ILD and 1 stomatitis). Treatment-related death was not observed. There were no significant change of QOL at baseline, after 4, 8, and 12 weeks. PK analyses showed steady state plasma concentration as 22.8 ng/mL which was comparable to reported plasma concentration of 40 mg afatinib in LUX-LUNG3 and 6 (24.3 ng/mL). No obvious PK differences were found according to dose reduction, adverse event, and response.
Conclusion
Afatinib at 30 mg/day could be an effective treatment option for elderly patients, over 75 years of age, with good PS. (UMIN 0000177050)
-
+
P2.04 - Immuno-oncology (ID 167)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
-
+
P2.04-87 - Efficacy of Immune Checkpoint Inhibitors for Locally Advanced Non-Small Cell Lung Cancer Patients Before Durvalumab Approval (Now Available) (ID 878)
10:15 - 18:15 | Author(s): Satoshi Igawa
- Abstract
Background
Standard treatment for patients with locally advanced (LA) non-small cell lung cancer (NSCLC) was concurrent chemoradiotherapy (CRT) with 40-70% of 2-year overall survival (OS). Immune checkpoint inhibitors (ICIs) have been shown efficacy in advanced or recurrent NSCLC and approved on December 2015 in Japan. After that, the ICI durvalumab was approved as maintenance therapy after concurrent CRT even in unresectable LA-NSCLC on July 2018 in Japan.
Method
To investigate the feasibility of concurrent CRT for LA-NSCLC patients and efficacy of ICI treatment for the relapsed patients after CRT, we assessed consecutive LA-NSCLC patients treated with concurrent CRT between July 2013 and June 2018 (before durvalumab approval), retrospectively.
Result
108 eligible patients (81 males and 27 females with median age of 65 years old, including 7 patients with targeted mutations; 2 EGFR, 4 ALK and 1 ROS1) were analyzed. All patients received radical thoracic radiotherapy using 3D planning system and concurrent with platinum-based chemotherapy. 79 (73%) received one or two cycles of consolidation chemotherapy of same regimen. 105 (97%) patients completed planned radiotherapy, and radiation pneumonitis was observed in 93 (85%) patients with median 130 (range, 41-317) days from initiation of radiation to onset. 74 (69%) patients met the PACIFIC criteria and were considered to be eligible for durvalumab. The overall response rate was 64% and the progression free survival was 10.3 (95% CI, 8.4–12.2) months. The OS was 41.8 (95%CI, 20.1-63.5) months and 2-year OS were 63%. Of the 82 patients who relapsed after CRT, 18 patients received ICI treatment (14 nivolumab, 3 pembrolizumab, 1 atezolizumab) in the course of treatment. Patients who received ICI after relapse had significantly better survival than those who did not receive ICI (2-year OS, 87% vs. 41%; p=0.001).
Conclusion
Concurrent CRT using platinum-based regimen was considered effective treatment with acceptable toxicity for LA-NSCLC patients. The efficacy of ICI treatment has been shown in patients with relapse after concurrent CRT in LA-NSCLC, and indication with durvalumab maintenance therapy is expected to further improve the prognosis in patients with LA-NSCLC. The optimal use timing of ICI treatment for patients with LA-NSCLC should be considered.
