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Akane Ishida
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EP1.04 - Immuno-oncology (ID 194)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.04-33 - Pembrolizumab with High PD-L1: Who Are Non-Responders? (Now Available) (ID 3003)
08:00 - 18:00 | Author(s): Akane Ishida
- Abstract
Background
Pembrolizumab is a programmed death-1 (PD-1) blockade which is approved for non-small cell lung cancer (NSCLC). It has been reported that programmed death-ligand 1 (PD-L1) high patients are more effective than low patients to pembrolizumab. It has not been clear what factors decide responsiveness to pembrolizumab in PD-L1 high patients.
Method
NSCLC patients who had been given pembrolizumab from April 2017 to October 2018 in Nagoya Medical Center and whose PD-L1 tumor proportion score (TPS) was ≥50% were included. A double cancer case was excluded. The non-effective group was made of patients who had stable and progressive diseases, and the effective group was made of patients who had complete and partial response. We compared the non-effective group with the effective group.
Result
Data were extracted retrospectively from patients' medical records. In total, 34 patients received pembrolizumab. One patient who had double cancer and 7 patients whose PD-L1 TPS was <50% were excluded from this analysis. Twenty-six patients were included. In 26 patients, 19 men (73.1%), 22 current or former smokers (84.6%). The median age was 69 (ranged 48–88). Patients with adenocarcinoma, adenosquamous, squamous, not otherwise specified, and pleomorphic carcinoma were 15/1/ 8/1/1. Stage IIIA, IIIB, IV, and recurrence after surgery were 1/2/16/ 7. Performance status (PS) 0, 1, 2, 3, and 4 were 7/9/7/ 2/1. First, second, and fourth lines of chemotherapy were 18, 7, and 1, respectively. Differences between pembrolizumab effective and non-effective group in gender, smoking history, age, tissue type, proportion of stage IV, and treatment line were not statistically different. In terms of PS, all PS 3 or 4 patients were non-effective.
Conclusion
In NSCLC PD-L1 high patients treated with pembrolizumab, PS 3–4 might be a factor, which indicated poor response to pembrolizumab.
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MA21 - Non EGFR/MET Targeted Therapies (ID 153)
- Event: WCLC 2019
- Type: Mini Oral Session
- Track: Targeted Therapy
- Presentations: 1
- Now Available
- Moderators:Benjamin Besse, Michael Thomas
- Coordinates: 9/10/2019, 14:30 - 16:00, Vienna (2016)
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MA21.05 - Phase II Trial of the Combination of Alectinib with Bevacizumab in ALK-Positive Nonsquamous Non-Small Cell Lung Cancer (Now Available) (ID 1306)
14:30 - 16:00 | Author(s): Akane Ishida
- Abstract
- Presentation
Background
Alectinib is a 2nd generation highly selective anaplastic lymphoma kinase (ALK) inhibitor. Although alectinib has improved progression-free survival (PFS) in patients with ALK-positive Non-Small Cell Lung Cancer (NSCLC), there are limited treatment options after progression of alectinib. Recent evidences have described promising results of the combination of bevacizumab with EGFR-TKIs, cytotoxic chemotherapies and immune-checkpoint inhibitors. We report the results from a phase II study of the combination of alectinib with bevacizumab in ALK-positive Nonsquamous NSCLC patients who were treated with alectinib and showed disease progression (UMIN 000017828).
Method
Patients with ALK+ Nonsquamous NSCLC who had progressed after alectinib treatment were enrolled. Primary objective of this study was PFS and safety. Secondary endpoints included overall survival, objective response rate and disease control rate.
Result
Twelve patients received alectinib (600 mg/day) with bevacizumab (15 mg/kg, Q3W). Nine patients were treated with crizotinib and alectinib, and 2 patients were treated with crizotinib, alectinib and ceritinib before enrollment to this study. The median PFS was 3.1 months (95% CI 1.2-16.1) and the median survival time was 32 months (95% CI 8.3-NE). The median treatment cycle was 5 (range, 1-37) and 3 patients received alectinib with bevacizumab more than 20 cycles. The objective response rate and disease control rate were 8% and 67%, respectively. The most common treatment related adverse events were decreased appetite (42%), proteinuria (42%), hypertension (33%), anemia (33%) and fatigue (33%). Treatment related adverse events of grade > 3 were anemia (8%), proteinuria (8%), diarrhea (8%) and hypokalemia (8%). No severe adverse events were observed.
Conclusion
This is the first study to investigate the combination of alectinib and bevacizumab. This combination had clinical efficacy and was well tolerated.
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