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Koichi Minato



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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): Koichi Minato

      • Abstract
      • Slides

      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): Koichi Minato

      • Abstract
      • Slides

      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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