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Hirokazu Taniguchi
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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): Hirokazu Taniguchi
- 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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P2.14 - Targeted Therapy (ID 183)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.14-11 - Retreatment with EGFR-TKI for 541 NSCLC Patients with EGFR Mutation (ID 2633)
10:15 - 18:15 | Author(s): Hirokazu Taniguchi
- Abstract
Background
Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) is remarkably effective against non-small cell lung cancer (NSCLC) harboring EGFR activating mutation. However, tumors almost inevitably develop resistance approximately after one year of EGFR-TKI treatment. In addition, some patients can not tolerate an EGFR-TKI treatment because of adverse events and result in discontinuation of the treatment. In such cases, the same or other EGFR-TKI may be re-administered. However, its efficacy is not fully evaluated.
Method
We retrospectively investigated patients who received EGFR-TKI between January 2008 and August 2017. Among these patients, the response rate and time to treatment failure (TTF) for each re-administered TKI were assessed. We assessed each TTF for patients who discontinued the prior EGFR-TKI because of progressive disease (PD group) and patients who discontinued TKI because of adverse events (AE group). We also evaluated the overall survival (OS) for the patients who received the retreatment with EGFR-TKI and who did not.
Result
A total of 1400 patients from 11 institutions were enrolled in this study. Among them, 570 patients received retreatment with EGFR-TKI, and 541 were eligible. Among the 395 patients who discontinued prior EGFR-TKI because of disease progression, the response rate and the median TTF of subsequent Gefitinib/Erlotinib/Afatinib were 8%/8%/18%, and 4.9/3.2/4.3 months, respectively. The median TTF for the AE group was significantly longer than that for the PD group (10.8 months vs 3.8 months, p<0.0001). In the AE group, The OS for patients receiving retreatment with EGFR-TKI was significantly better than the OS for patients without retreatment (Hazard Ratio = 0.256, p < 0.0001). Similarly, in the PD group, the OS for patients receiving retreatment with EGFR-TKI was significantly better than the OS for patients without retreatment (Hazard Ratio = 0.456, p < 0.0001).
Conclusion
Retreatment with EGFR-TKI was shown to be effective for both patients who discontinued prior EGFR-TKI because of disease progression as well as adverse events.
