Virtual Library

Start Your Search

Nuno China



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
    • +

      EP1.01-80 - Progressive Disease with T790M Mutation vs Non-T790M Mutation in EGFR Positive Patients Treated with Tyrosine Kinase Inhibitors (ID 2781)

      08:00 - 18:00  |  Author(s): Nuno China

      • Abstract
      • Slides

      Background

      Patients with metastatic non-small cell lung cancer (NSCLC) with a sensitizing EGFR mutation are candidates for treatment with a tyrosine kinase inhibitor (TKI), but acquired resistance is inevitable. The most frequent mechanism of acquired resistance to TKI is the T790M mutation.

      Method

      Retrospective analysis of patients with EGFR mutation treated with TKI who progressed from November 2016 to July 2018, for whom the T790M mutation testing was done through liquid or tissue biopsy.

      Result

      Progression disease was observed in 18 patients. The mean age was 67.1 ± 14.4 years. Twelve patients (66.7%) were female. Ten patients (55.5%) presented the T790M mutation as a resistance mechanism to TKI.

      T790M positive T790M negative p value

      Non-smokers

      Ever smokers

      9 (90%)

      1 (10%)

      2 (25 %)

      6 (75 %)

      0.005

      EGFR mutation

      Exon 18

      Exon 19

      Exon 21

      0 (0%)

      8 (80%)

      2 (20%)

      1(12.5%)

      5(62.5%)

      2 (25%)

      0.604

      Initial TKI

      Gefitinib

      Afatinib

      Erlotinib

      2 (20%)

      0 (0%)

      8 (80%)

      2 (25%)

      3(37.5%)

      3(37.5%)

      0.146

      Response evaluation

      Stable disease

      Partial response

      3 (30%)

      7 (70%)

      6 (75%)

      2 (25%)

      0.119
      PFS with initial TKI - months (mean ± SD) 11 ± 5.3 10 ± 6.9 0.586
      Months treated with initial TKI after disease progression due to clinical benefit (median - IQR) 2 - 5 4 - 3 0.409

      Progressive disease

      Increase of primary lesion size

      Increase of metastasis size

      New intrathoracic lesions

      New extrathoracic ± intrathoracic lesions

      3 (30%)

      3 (30%)

      2 (20%)

      2 (20%)

      3(37.5%)

      2 (25%)

      0 (0%)

      3(37.5%)

      0.465

      Conclusion

      The T790M mutation was the most frequent mechanism of TKI resistance. Non-smokers developed the mutation more often than ex-smokers, although this result was not statistically significant. In the other analyzed variables there were no statistically significant differences.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    EP1.04 - Immuno-oncology (ID 194)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Immuno-oncology
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
    • +

      EP1.04-10 - Nivolumab in Non-Small Cell Lung Cancer (NSCLC): A Real-Life Study (ID 2012)

      08:00 - 18:00  |  Author(s): Nuno China

      • Abstract
      • Slides

      Background

      Immunotherapy is an option in locally advanced or metastatic lung cancer (LC), depending on the PD-L1 value. Nivolumab, an anti-PD1 immunological checkpoint inhibitor, can be used in LC in subsequent lines, regardless of the PD-L1 value. The aim of this study was to analyze patients with LC treated with nivolumab in the Multidisciplinary Thoracic Tumor Unit (MTTU) of our hospital.

      Method

      Retrospective analysis of patients treated in the MTTU of our hospital who with nivolumab in subsequent lines between Dec-2015 and Dec-2018.

      Result

      49 patients were enrolled in this study with a mean age at the start of immunotherapy of 62.1 ± 9.1 years. 38 patients (77.6%) were male. Regarding the histological type, 30 (61.2%) were adenocarcinomas, 16 (32.7%) squamous cell carcinomas and 3 (6.1%) corresponded to other histological types. Regarding the expression of PD-L1, 30 patients (61.2%) had no expression, 13 (26.5%) had PD-L1 ≥1%, and in 6 patients (12.2%) this parameter was unknown. 27 patients (55.1%) were treated with 1 prior therapeutic line, 12 patients (24.5%) with 2 and 10 patients (20.3%) with > 2 previous therapeutic lines. With immunotherapy, 7 (14.3%) had partial response, 22 (44.9%) stable disease and 12 (24.5%) progressive disease. 28 patients (57.1%) have died so far.

      The median PFS was 5 months (95% CI 1.4-8.6) and the median overall survival (OS) was 10 months (95% CI 7.6-12.4). There were no significant differences between patients with or without PD-L1 expression.

      Conclusion

      The OS of our patients treated with nivolumab was slightly lower than some literature which perhaps is related to the fact that this is a real-life study, patients had a high number of previous therapeutic lines and there were different histologic types of LC.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    P1.04 - Immuno-oncology (ID 164)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Immuno-oncology
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
    • +

      P1.04-61 - Neutrophil-Lymphocyte Ratio: A Predictive Biomarker of Immunotherapy in Lung Cancer? (Now Available) (ID 2176)

      09:45 - 18:00  |  Presenting Author(s): Nuno China

      • Abstract
      • Slides

      Background

      Identifying predictive biomarkers of immunotherapy in advanced non-small cell lung cancer (NSCLC) is essential to select the patients that could benefit more from this revolutionary therapy. Besides PD-L1 expression, neutrophil-lymphocyte ratio (NLR) has been explored as a potential predictor of clinically meaningful outcomes.

      Aim: Assess if NLR is an independent predictor of response to immunotherapy in advanced NSCLC.

      Method

      Retrospective study of patients with locally advanced or metastatic NSCLC treated with immunotherapy in the second or further lines setting in a Multidisciplinary Thoracic Tumor Unit between 2015 and 2018. Pre-treatment NLR was calculated from baseline peripheral blood cell counts. NLR was categorized as a binary variable: “low” (<5) or “high” (≥5). Cox regression models were used for overall survival (OS) and progression-free survival (PFS) analysis.

      Result

      From a total of 63 patients, 49 were treated with nivolumab and 14 with pembrolizumab. At the beginning of immunotherapy, baseline patient characteristics were: men: 79.4%; median age (IQR): 62 (56-70) years; ever smokers: 82.5%; ECOG PS 0-1: 82.5%; adenocarcinoma: 63.5%; squamous cell carcinoma: 31.7% and NSCLC-NOS: 4.8%; stage IV: 76.2%; PD-L1 expression <1%: 47.6%. Twenty three patients (36.5%) received immunotherapy in the third or further lines of treatment. Median PFS and OS were 5 months (2-10) and 8 months (4-13), respectively. After adjusting for gender, age, tobacco habits, ECOG PS, histology and PD-L1 expression, "high" NLR was an independent predictive factor of worse PFS (HR 2.22; 95% CI 1.06-4.66; p 0.035) and OS (HR 2.74; 95% CI 1.19-6.30; p 0.017).

      Conclusion

      In our cohort, patients with NLR≥5 had a higher risk of disease progression and death compared to those with NLR<5. NLR is an inexpensive and affordable biomarker that could help to predict response to immunotherapy. Further large prospective studies are needed to validate this biomarker and to establish the optimal cut-off level.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.