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Tomoki Kimura
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P2.04 - Immuno-oncology (ID 167)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.04-21 - Serum CRP Decrease Has Predictive Value for Long-Term Disease Control by PD-1/ PD-L1 Inhibitors in Patients with NSCLC (ID 305)
10:15 - 18:15 | Author(s): Tomoki Kimura
- Abstract
Background
Several studies showed the predictive or prognostic value of systemic inflammatory markers such as C-reactive protein (CRP) in patients with non-small cell lung cancer (NSCLC) treated with PD-1/PD-L1 inhibitors. In OAK study, serum CRP decrease at 6 weeks from baseline was associated with the favorable clinical efficacy of atezolizumab, a PD-L1 inhibitor. However, the result is not validated in the clinical practice setting including patients treated with anti PD-1 antibodies. The aim of this study is to investigate the significance of serum CRP change from baseline as a biomarker in NSCLC patients treated with PD-1/PD-L1 inhibitors.
Method
The current study is a retrospective cohort study. NSCLC patients treated with anti-PD-1/PD-L1 inhibitors in 2nd or later line setting were reviewed at Nagoya University Hospital and Tosei General Hospital. Patients were divided into two groups by serum CRP change (Group 1; patients with serum CRP decrease at 6 weeks by >= 33% compared to the baseline, and Group 2; the others except Group 1).
Result
From January 2016 to September 2018, 124 advanced or recurrent NSCLC patients were enrolled. 34 (27.4%) patients were divided into Group 1 and 90 (72.6%) were into group 2, respectively. Group 1 showed statistically significant higher objective response rate compared with Group 2 (38.2% vs 7.0%, p< 0.01), and longer progression-free survival (PFS) (1-year PFS rate: 34.2% vs. 11.7%, HR of group 1 to group 2: 0.63 (95%CI: 0.39-0.98), p=0.04). Multivariate analysis also identified the CRP decrease as an independent favorable factor of PFS (adjusted HR of group 1 to group 2: 0.45 (95%CI: 0.26-0.77), p< 0.01). In contrast, PFS and OS were similar between the patients treated with PD-1 and PD-L1 inhibitors.
Conclusion
Serum CRP decrease at 6 weeks from baseline would have predictive value for long-term disease control by PD-1/PD-L1 inhibitors for NSCLC in the clinical practice setting.
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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): Tomoki Kimura
- 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.
