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Puyuan Xing



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    EP1.14 - Targeted Therapy (ID 204)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Targeted Therapy
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.14-19 - Efficacy and Safety of Afatinib for Advanced Lung Adenocarcinoma Patients with Sensitive EGFR Mutations in Chinese Population (Now Available) (ID 817)

      08:00 - 18:00  |  Author(s): Puyuan Xing

      • Abstract
      • Slides

      Background

      Afatinib is an irreversible ErbB family blocker that improves progression-free survival (PFS) of advanced EGFR-mutant lung adenocarcinoma, comparing with chemotherapy. However, afatinib leads to more adverse events than first-generation EGFR inhibitors. Hence, exploration of optimal afatinib initial dose and its efficacy and safety for Asian patients has drawn extensive attention.

      Method

      We retrospectively investigated advanced NSCLC patients treated with afatinib from February 27, 2017 to October 30, 2018. Demographic and clinical information, survival data and adverse events were collected and evaluated.

      Result

      A total of 60 patients were included into this study. Thirty-nine (65%) patients received afatinib as first-line treatment. Median PFS for first-line afatinib treatment was 15.64 months [95% confidence internal (CI), not reached] and median OS has not been reached. When including age, sex, smoking history, baseline brain metastasis status, afatinib starting dose and mutation types into a multivariate COX regression analysis, PFS of patients with common sensitive EGFR mutations only was significantly longer than that of patients with uncommon mutations [hazard ratio (HR), 0.256; 95%CI, 0.080-0.823; p=0.022]. No significant difference was observed in median PFS between patients treated with a starting dose of 40mg and 30mg (11.18 vs. 5.25 months, p=0.060). The incidence of all grades rash/acne (92.5% vs. 61.1%, p=0.011) and paronychia (82.5% vs. 50.0%, p=0.010) of 40mg group was significantly higher than that of 30mg group.figure 1.jpg

      Table 1. Afatinib-Related Adverse Events

      Adverse events

      All Patients

       

      Afatinib 40mg

       

      Afatinib 30mg

       

      N=58

      N=40

      N=18

      N

      %

       

      N

      %

       

      N

      %

      p

      Diarrhea

      50

      86.2

      36

      90.0

      14

      77.8

      0.402

      ≥Grade 3

      6

      10.3

      5

      12.5

      1

      5.6

      0.736

      Rash/acne

      48

      82.8

      37

      92.5

      11

      61.1

      0.011

      ≥Grade 3

      2

      3.4

      2

      5.0

      0

      0.0

      1.000

      Paronychia

      42

      72.4

      33

      82.5

      9

      50.0

      0.010

      ≥Grade 3

      2

      3.4

      2

      5.0

      0

      0.0

      1.000

      Stomatitis/mucositis

      41

      70.7

      29

      72.5

      12

      66.7

      0.652

      ≥Grade 3

      0

      0.0

      0

      0.0

      0

      0.0

      -

      Dry skin

      22

      37.9

      16

      40.0

      6

      33.3

      0.628

      ≥Grade 3

      0

      0.0

      0

      0.0

      0

      0.0

      -

      Pruritus

      9

      15.5

      7

      17.5

      2

      11.1

      0.818

      ≥Grade 3

      0

      0.0

       

      0

      0.0

       

      0

      0.0

      -

      Conclusion

      First-line afatinib treatment is beneficial to advanced lung adenocarcinoma with sensitive EGFR mutations. Initial dose and baseline brain metastasis status do not impact PFS significantly.

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    P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
    • +

      P2.16-08 - Clinical Characteristics and Outcomes of Patients with BRAF Mutated Non-Small Cell Lung Cancer (Now Available) (ID 1106)

      10:15 - 18:15  |  Author(s): Puyuan Xing

      • Abstract
      • Slides

      Background

      BRAF mutation is a driver oncogene identified in 0.5-2% of non-small cell lung cancer (NSCLC) patients in China, and clinical data are relatively inadequate. This study assessed the clinical characteristics, course of disease and treatment outcomes in patients with BRAF mutated NSCLC in a real-world setting.

      Method

      Between Apr 1, 2017 and Feb 1, 2019, medical data of patients with NSCLC harboring BRAF mutation in our cancer center was retrospective collected. Patient characteristics and treatment outcomes were reviewed. Data cutoff was Apr 1, 2019.

      Result

      A total of 36 patients were identified. BRAF V600E was the most common (31/36, 86.1%), other BRAF molecular subsets were observed in 5 (13.9%) cases including K601E, G469V, G596R and D594N. The majority of patients with BRAF mutation were female (20/36, 55.6%) and non-smokers (20/36, 55.6%), all of them were adenocarcinoma, and median age at diagnosis was 56 (range, 33-79). Twenty-seven patients were recurrent or metastatic NSCLC at data cutoff, most of whom received chemotherapy (16/27, 59.3%) as first-line therapy with median progression-free survival (PFS) of 9.8 months (95%CI 0.0, 21.5) and disease control rate (DCR) of 68.8% (11/16). Eight patients received anti-BRAF targeted therapy (including dabrafenib, trametinib and vemurafenib) in the first-line and showed superior efficacy than those received chemotherapy (median PFS, 15.9 months [95%CI, 4.5, 27.3] vs. 9.8 months [95%CI, 0.0, 21.5], P = 0.183; DCR, 100% vs. 68.8%, P = 0.130). As for distinct molecular subsets, most patients with V600E mutation were female (19/31, 61.3%) and non-smokers (19/31, 61.3%), while four of five (80.0%) patients with non-V600E mutation were male and smokers. All of the 3 patients in non-V600E mutations subgroup with recurrent or metastatic disease received chemotherapy in the first-line, and achieved 2 of SD, 1 of PD.

      efficacy.jpg

      Conclusion

      NSCLC with BRAF mutation was associated with specific characteristics, which were variable between molecular subsets. BRAF inhibitors should be considered firstly in treating patients with BRAF-mutated lung cancers. The prognosis value of non-V600E mutations and treatment selection needs more research.

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