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Ruiguang Zhang
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EP1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 206)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.16-14 - Efficacy of First-Line Continuous Maintenance of Pemetrexed Therapy for Lung Adenocarcinoma When Administered at Routine or Extended Intervals (Now Available) (ID 1822)
08:00 - 18:00 | Author(s): Ruiguang Zhang
- Abstract
Background
Background: Lung cancer is the most common cancer and the leading cause of death due to cancer worldwide , The benefit of maintenance therapy with pemetrexed with or without antiangiogenesis inhibitors has been observed in previous studies. However, continuous maintenance therapy with the pemetrexed-antiangiogenesis combination has rarely been evaluated in the real world setting. In real life, patients may not receive maintenance therapy or may receive delayed maintenance therapy (stopping interval of >21 days) owing to many factors. The purpose of this study was to obtain real-world data on the maintenance of local progressive and metastatic non-squamous non-small cell lung cancer (NSCLC) in first-line patients treated with or without pemetrexed antiangiogenesis, and to evaluate the effect of extended interention on clinical outcomes.
Method
Methods: 168 patients with stage IIIB or IV lung adenocarcinoma who had not been treated previously received pemetreplatin-induced chemotherapy with or without anti-angiogenesis inhibitors (bevacizumab or rh-endostatin) every 3 weeks for a course of 4-6 weeks.The efficacy and safety of 112 patients without progression after induction chemotherapy were analyzed.
Result
Results: 70 of the 112 patients received continuous maintenance therapy, with or without an anti-angiogenesis inhibitor, until the disease progressed.42 patients did not receive continuous maintenance therapy.The median duration of maintenance therapy was 4(range 1-26);The median interval of each maintenance treatment cycle was 40 days (ranged from 21 to 77 days).The optimal objective efficiency of maintenance group and non-maintenance group was 48.6% and 33.3%, respectively.At an average follow-up of 14.6 months, the median progression-free survival was 11.5 months (95% CI: 9.8 -13.2 months) and 6.8 months (95% CI :5.4-8.2 months,p < 0.001), and the median overall survival was 40.1 months (22.5 - 57.7 months) and 18.0 months (10.4-25.6 months,p = 0.001) in the maintenance and non-maintenance groups, respectively.The most common grade 3-4 adverse event in both groups was neutropenia (18.6% vs. 19.0%).
Conclusion
Conclusion: prolongation of maintenance time is feasible, and for patients without progression after first-line induction therapy for lung adenocarcinoma, continuous maintenance therapy with or without combination of pemetrexed with anti-angiogenesis is essential for survival benefits.
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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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P2.01-34 - Endostar Combined with Whole Brain Radiotherapy in Patients with NSCLC Brain Metastases (Now Available) (ID 1956)
10:15 - 18:15 | Author(s): Ruiguang Zhang
- Abstract
Background
Brain metastasis (BM) is the leading cause of poor prognosis, recurrence, and death in non-small-cell lung cancer (NSCLC) patients. The effectiveness of whole-brain radiotherapy is unsatisfactory. Endostar was reported as an anti-angiogenic agent, which could promote vascular normalization in tumor. This study is to investigate the influence of endostar combined with cranial radiation to survival, cerebral blood flow, immune status and quality of life of the patients.
Method
28 NSCLC patients with multiple brain metastasis（more than four）were randomly divided into two groups. The experimental group (n = 14) received WBRT (30Gy/10F) combined with Endostar (15mg/m2, 7days), and the control group (n=14) received WBRT (30Gy/10F) alone. Tumor progression and survival of the patients were established by certified oncologists based on whole brain MRI scan. Magnetic resonance perfusion imaging was carried out pre- and one month post-radiation to detect regional cerebral blood volume (rCBV), regional cerebral blood flow (rCBF), mean transit time (MTT) and transit time to peak (TTP) of the contrast medium. The changes of blood T lymphocyte subpopulation, the cognitive function and overall healthy level were evaluated pre- and post- radiation every two months against the MMSE, MoCA and EORTC QLQ-C30 scales.
Result
The median progression free survival (mPFS) was 211 days vs. 84 days (P=0.2204), while the median intracranial PFS (miPFS) was 333 days vs. 192 days (P=0.1882) and the median extracranial PFS (mePFS) was 311 days vs. 84 days (P=0.0873) between the Endostar group vs. the control group, but neither with significant difference, may for the limit of sample size. Moreover, compared with the control group, rCBF of the lesion in the Endostar group decreased more evidently (-69.0286±87.4532 vs. -25.3444±233.4, P=0.6158), rCBV decreased slightly (-13.1286±389 vs. -510.8±800.1, P=0.1545), MTT increased (69.0571±1190.7 vs. -483.3±1885.1, P=0.5108) and TTP increased (156.6±1232.8 vs. 102.1±864.1, P=0.9185), indicating that endostar group had a better control of the cerebral perfusion and the tumor. The T lymphocyte subpopulation increased in the Endostar group, especially the CD3+CD8+ T lymphocyte but without significant difference compared with the control group(P=0.1447). At the same time, after cranial radiation, the cognitive function, physical, role, social and emotional functions improved in the endostar group, while a small fluctuation in the control group with significant difference(P<0.05).
Conclusion
Our study showed that endostar could improve survival of the patients, adjust cerebral perfusion and promote control of lesions, ameliorate the immune status, while improve cognitive function and quality of life of the patients at the same time.
