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Itaru Soda



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    EP1.12 - Small Cell Lung Cancer/NET (ID 202)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Small Cell Lung Cancer/NET
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.12-36 - Treatment Outcomes and Risk Factors of Limited-Stage Small Cell Lung Cancer Patients Treated with Chemoradiotherapy (Now Available) (ID 442)

      08:00 - 18:00  |  Author(s): Itaru Soda

      • Abstract
      • Slides

      Background

      The aim of this study was to report clinical outcomes and prognostic factors in limited- stage small cell lung cancer (LD-SCLC) patients treated with chemoradiotherapy (CRT).

      Method

      Data on 107 LD-SCLC patients who received CRT between September 2000 and March 2017 were analyzed retrospectively. The median age of the patients was 66 years (range 42–85 years); 79 (73.8%) patients were male and 28 (26.2%) were female. Seventy-four (69.2%) patients received concurrent CRT (CCRT) with 45 Gy in 30 twice-daily fractions (n=52) or with 54–60 Gy in 27–30 once-daily fractions (n=22). The other 33 patients received sequential CRT (SCRT) with 54–60 Gy in 27–30 once-daily fractions. Prophylactic cranial irradiation was administered to 35 (32.7%) patients. Cisplatin/etoposide or carboplatin/etoposide were mainly selected as chemotherapy regimens. Survival rates were estimated using the Kaplan-Meier method, and univariate and multivariate analysis was performed using the log-rank test and Cox proportional hazard model, respectively.

      Result

      Median follow-up duration was for 28.6 months (range 1.6–147.2 months). Three-year overall survival, progression-free survival and cause-specific survival rates were 51.1%, 38.8% and 51.5%, respectively.

      On univariate analysis metastatic lymph node status (N0 vs N≥1) and timing of CRT (CCRT vs SCRT) were detected as significant prognostic factors for overall survival (3-year overall survival: 100% vs 48.2%, p=0.02; and 56.6% vs 37.7%, p=0.04, respectively). On multivariate analysis, however, these factors did not reach statistical significance.

      Conclusion

      Treatment outcomes in LD-SCLC patients suggested metastatic lymph node status and timing of CRT as prognostic factors for overall survival.

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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
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.04-87 - Efficacy of Immune Checkpoint Inhibitors for Locally Advanced Non-Small Cell Lung Cancer Patients Before Durvalumab Approval (Now Available) (ID 878)

      10:15 - 18:15  |  Author(s): Itaru Soda

      • Abstract
      • Slides

      Background

      Standard treatment for patients with locally advanced (LA) non-small cell lung cancer (NSCLC) was concurrent chemoradiotherapy (CRT) with 40-70% of 2-year overall survival (OS). Immune checkpoint inhibitors (ICIs) have been shown efficacy in advanced or recurrent NSCLC and approved on December 2015 in Japan. After that, the ICI durvalumab was approved as maintenance therapy after concurrent CRT even in unresectable LA-NSCLC on July 2018 in Japan.

      Method

      To investigate the feasibility of concurrent CRT for LA-NSCLC patients and efficacy of ICI treatment for the relapsed patients after CRT, we assessed consecutive LA-NSCLC patients treated with concurrent CRT between July 2013 and June 2018 (before durvalumab approval), retrospectively.

      Result

      108 eligible patients (81 males and 27 females with median age of 65 years old, including 7 patients with targeted mutations; 2 EGFR, 4 ALK and 1 ROS1) were analyzed. All patients received radical thoracic radiotherapy using 3D planning system and concurrent with platinum-based chemotherapy. 79 (73%) received one or two cycles of consolidation chemotherapy of same regimen. 105 (97%) patients completed planned radiotherapy, and radiation pneumonitis was observed in 93 (85%) patients with median 130 (range, 41-317) days from initiation of radiation to onset. 74 (69%) patients met the PACIFIC criteria and were considered to be eligible for durvalumab. The overall response rate was 64% and the progression free survival was 10.3 (95% CI, 8.4–12.2) months. The OS was 41.8 (95%CI, 20.1-63.5) months and 2-year OS were 63%. Of the 82 patients who relapsed after CRT, 18 patients received ICI treatment (14 nivolumab, 3 pembrolizumab, 1 atezolizumab) in the course of treatment. Patients who received ICI after relapse had significantly better survival than those who did not receive ICI (2-year OS, 87% vs. 41%; p=0.001).

      Conclusion

      Concurrent CRT using platinum-based regimen was considered effective treatment with acceptable toxicity for LA-NSCLC patients. The efficacy of ICI treatment has been shown in patients with relapse after concurrent CRT in LA-NSCLC, and indication with durvalumab maintenance therapy is expected to further improve the prognosis in patients with LA-NSCLC. The optimal use timing of ICI treatment for patients with LA-NSCLC should be considered.

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