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Hisashi Mitsufuji



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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
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      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  |  Author(s): Hisashi Mitsufuji

      • Abstract
      • Slides

      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.

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    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
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      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): Hisashi Mitsufuji

      • Abstract
      • Slides

      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.

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