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Hisao Imai
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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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EP1.01-83 - Efficacy and Safety of EGFR-TKI Rechallenge Treatment in Elderly Patients with Advanced NSCLC Harboring Sensitive EGFR Mutations (Now Available) (ID 81)
08:00 - 18:00 | Author(s): Hisao Imai
- Abstract
Background
Epidermal growth factor receptor–tyrosine kinase inhibitor (EGFR–TKI) is effective as first-line chemotherapy for patients with advanced non-small-cell lung cancer (NSCLC) harboring sensitive EGFR mutations. However, whether the efficacy of second-line EGFR–TKI treatment after first-line EGFR–TKI treatment was poorly studied in elderly patients aged ≥ 75 years harboring sensitive EGFR mutations. Therefore, we aimed to investigate the efficacy and safety of EGFR-TKI re-administration after first-line EGFR–TKI treatment in elderly patients with NSCLC harboring sensitive EGFR mutations.
Method
Between October 2002 and December 2015, 22 elderly patients with advanced NSCLC harboring sensitive EGFR mutations who were initiated on EGFR–TKI Rechallenge at four Japanese institutions were included in this study.
The eligibility criteria were histologically or cytologically confirmed NSCLC, unresectable stage III/IV disease, and a drug-sensitive EGFR mutation (exon 19 deletion or exon 21 L858R).
All patients were initially treated with gefitinib (250 mg/day) or erlotinib (150 mg/day) and after recurrence, re-administration of EGFR-TKIs (gefitinib, erlotinib, afatinib) was performed as a secondary chemotherapy
Result
Ultimately, 22 cases of this study were studied. The median age was 77.5 years (range 75-87 years).
Although it was a retrospective analysis, even with re-administration of EGFR-TKI rechallenge, the response rate was 23%, PFS 5.26 months, OS (after EGFR-TKI rechallenge) 14.4 months (the administration lines were 2, 3 and 4 lines ).
Conclusion
Until now it was said that EGFR-TKI rechallenge does not contribute to OS in LUX-LUNG 1 and so on.
On the other hand, there are also reports on the usefulness of EGFR-TKI rechallenge.
From the results of this study it can be said that it can be one of the options among the limited treatment options for elderly EGFR positive lung cancer.
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P1.04 - Immuno-oncology (ID 164)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.04-34 - Efficacy and Safety of First-Line Pembrolizumab Monotherapy in Elderly Patients (Aged ≥ 75 years) with Non-Small Cell Lung Cancer (ID 265)
09:45 - 18:00 | Author(s): Hisao Imai
- Abstract
Background
Pembrolizumab is effective as first-line treatment for advanced non-small cell lung cancer (NSCLC) patients expressing high programmed death-ligand 1 (PD-L1). However, it is unclear whether the efficacy of first-line pembrolizumab treatment in elderly patients (aged ≥75 years) is similar to that in non-elderly patients expressing high PD-L1. Therefore, we aimed to investigate the efficacy and safety of first-line pembrolizumab monotherapy in elderly patients with NSCLC expressing high PD-L1.
Method
Between February 2017 and February 2018, 128 patients (comprising 47 elderly) with advanced NSCLC expressing high PD-L1 received first-line pembrolizumab monotherapy at 10 Japanese institutions. Baseline characteristics, efficacy of pembrolizumab treatment, and adverse events were recorded.
Result
Overall, 47 patients (40 men and 7 women) (median age, 79 [range, 75–88] years) were included in our analysis. In these patients who received first-line pembrolizumab monotherapy, the overall response, disease control rates, median progression-free survival (PFS), and overall survival (OS) were 53.1%, 74.4%, 7.0 months, and not reached, respectively. Common adverse events included anorexia, fatigue, skin rash, and hypothyroidism. Two treatment-related deaths due to pneumonitis and infection were noted. First-line pembrolizumab monotherapy with non-progressive disease (PD) was associated with better PFS. Pembrolizumab monotherapy with good performance status and non-PD was also linked to better OS.
Conclusion
First-line pembrolizumab monotherapy among elderly patients with NSCLC expressing high PD-L1 was effective and safe and showed outcomes equivalent to those in non-elderly patients. First-line pembrolizumab monotherapy without PD, and with good performance status and non-PD, might be associated with better PFS and OS, respectively.
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P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.16-18 - Opioid-Induced Constipation in Patients with Cancer Pain in Japan (OIC-J study): A Post-Hoc Analysis of Lung Cancer Patients (ID 214)
10:15 - 18:15 | Presenting Author(s): Hisao Imai
- Abstract
Background
Opioid-Induced Constipation (OIC) is a common side effect of opioid analgesic therapy. OIC-J study was a multicenter, prospective, observational study of cancer patients who started opioid therapy in Japan (UMIN000025864). The aim of this post-hoc analysis was to clarify the OIC burden focusing on lung cancer patients.
Method
This post-hoc analysis was conducted by using a lung cancer patient’s data from OIC-J study. The incidence of OIC was determined by ROME IV diagnostic criteria based on the record of patient diary for 2 weeks, physician’s assessment, spontaneous bowel movement (SBM; <3 SBM/week), Bowel Function Index (BFI; score >28.8) and Patient’s assessment. The change in the Patient Assessment of Constipation-Symptoms (PAC-SYM) score and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) score in 2 weeks after starting opioids were compared between OIC patients and non-OIC patients determined by ROME IV diagnostic criteria.
Result
67 lung cancer patients from 212 in total cancer patients who were registered in OIC-J study were included in this analysis. The incidence of OIC was 48.0% (ROME IV diagnostic criteria), 59.1 % (physician’s assessment), 39.1% (SBM) and 53.0% (BFI), respectively. The incidence of OIC by patient’s assessment was 43.5% in 2 weeks after starting opioids (40.3% at a week after staring opioids). The change in PAC-SYM and PAC QOL score in OIC-patients compared to non-OIC patients were 0.399 vs -0.122 (p=0.0031) and 0.214 vs -0.016 (p=0.0540), respectively.
Conclusion
The OIC can occur quickly after the initiation of opioid therapy in lung cancer patients and can have an impact on patient’s QOL. These results suggest that an OIC management focusing on a quality and patient’s feeling of bowel movement in early stage in opioid analgesic therapy is important for lung cancer patients.
