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Xiaoqing Yu
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P1.01 - Advanced NSCLC (ID 158)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.01-100 - Effect of Osimertinib in Non-Small Cell Lung Cancer Patients with Brain Metastases After Progression Following Front-Line EGFR-TKI Therapy (Now Available) (ID 2985)
09:45 - 18:00 | Author(s): Xiaoqing Yu
- Abstract
Background
Osimertinib has been adopted as the standard of care for T790M-mediated acquired epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) resistance. In this study, we aim to investigate the effect of osimertinib in advanced NSCLC with brain metastases after the failure of first-line therapy.
Method
We retrospectively studied 43 NSCLC patients with BM received osimertinib after progression following front-line EGFR-TKI therapy from January 2013 to December 2016 at our institution. Overall survival (OS) was measured from the date of brain metastases.
Result
Among the 43 patients, 25(58.1%) received EGFR-TKIs as first-line therapy, 15(34.9%) were treated with EGFR-TKIs therapy after the progression of chemotherapy, and there’re also 3(7.0%) received the combination of EGFR-TKIs and chemotherapy as first-line therapy. 16(37.2%) were EGFR T790M positive, 4(9.3%) were EGFR T790M negative and 23(53.5%) were unknown T790M status. 34(79.1%) patients had received local radiation therapies (RT). The median overall survival (OS), and the median intracranial progression free survival (iPFS) was 32.0 months, 14 months, respectively. Patients with EGFR T790M mutation had the median OS of 24.7 months, these without T790M mutation had the median OS of 17.0 months, and the patients with unknown status of T790M showed the longest OS of 34.4months, although it did not reach statistical significance (P =0.727). There was also no difference in iPFS among the T790M-positive group, T790M-negetive group and the unknown status group (5.0 vs. 7.0 vs. 18.0 months, P=0.195). Similar results in OS were found among the first line TKIs group, chemotherapy followed by EGFR-TKI therapy group and the combination of TKIs and chemotherapy group (P=0.491). Three patients had leptomeningeal metastasis (LM), showed to have a worse iPFS of 12 months compared to 14 months of these without LM (P=0.991).
Conclusion
Osimertinib had a good efficacy in patients with brain metastasis of advanced non–small-cell lung cancer in whom disease had progressed following front-line EGFR-TKIs.
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P2.01 - Advanced NSCLC (ID 159)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.01-71 - Comprehensive Analysis of EGFR T790M-Mutant Abundance of Different Technologies and Its Effect on Efficacy of Osimertinib in Advanced NSCLC (Now Available) (ID 2573)
10:15 - 18:15 | Author(s): Xiaoqing Yu
- Abstract
Background
Osimertinib has been adopted as the standard of care for T790M-mediated acquired epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) resistance. And detecting EGFR T790M mutation can be challenging in routine care, low abundance of the mutation and difficulty for re-biopsy in patients with advanced disease. We aim to compare droplet digital PCR (ddPCR) and next generation sequencing (NGS) in T790M mutation testing, and analyze whether the abundance of T790M mutation is associated with the efficacy of osimertinib in advanced Non–small cell lung cancer (NSCLC).
Method
We retrospectively studied 132 T790M-positive advanced NSCLC patients who have received osimertinib after acquired TKI resistance from April 2017 to August 2018 at our institution. Treatment response was evaluated and survival data were collected and analyzed.
Result
Among the 132 patients, 18(13.6%) had adopted amplifcation refractory mutation system (ARMS), 58(43.9%) adopted ddPCR, 43(32.6%) used NGS in T790M testing, and the detection methods of 13(9.9%) patients were unknown. Data of T790M-mutatnt abundance were obtained in 64 patients, 57 of whom were tested by ddPCR in plasma and the other 7 by NGS. The median progression free survival (PFS) was 15 months, median OS was not reached, objective response rate (ORR) was 88%. We found that ARMS, ddPCR, NGS have no difference in T790M testing (p=0.114). Among the 57 ddPCR testing patients with the abundance of T790M, there was no difference in PFS of T790M abundance in the cutoff value of 0.5 (p=0.303).
Conclusion
Our results suggest that ARMS, ddPCR and NGS are all useful and reliable methods in EGFR T790M mutation detection. And the association between the abundance of T790M mutation using ddPCR in plasma and the efficacy of osimertinib seemed not strong and remained to be explored.
