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Tetsuya Okano
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EP1.04 - Immuno-oncology (ID 194)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.04-26 - Efficacy and Safety of Anti-PD-1 Inhibitors in Elderly Patients with Advanced Non-Small Cell Lung Cancer (Now Available) (ID 2107)
08:00 - 18:00 | Author(s): Tetsuya Okano
- Abstract
Background
Recently, the proportion of elderly patients with advanced non-small cell lung cancer (NSCLC) has increased. However, those patients cannot occasionally continue to receive systemic therapy due to adverse events (AEs) or decreased performance status (PS). There are few reports which address efficacy and safety of anti-PD-1 inhibitors as the second line therapy for such elderly patients. The purpose of this study is to evaluate the efficacy and feasibility of anti-PD-1 inhibitors for elderly patients with advanced NSCLC are controversial.
Method
We retrospectively evaluated the efficacy and feasibility of anti-PD-1 inhibitors in 14 elderly patients (≥ 75 years old) with advanced NSCLC, comparing with 53 non-elderly patients (< 75 years old). All patients received anti-PD-1 inhibitors as the second line therapy or later.
Result
Of the 14 elderly patients, 11 patients had PS score 0 or 1. Anti-PD-1 inhibitors included nivolumab in 11 patients and pembrolizumab in 3 patients, and the median courses of anti-PD-1 inhibitors was 7 (1-27). There was no difference in patient background between the elderly group and the non-elderly group. The objective response rate (ORR) was 43% in the elderly group, while the rate was 30% in the non-elderly group (p = 0.33). The median progression-free survival (PFS) was 12.1 and 11.1 months in the elderly and non-elderly group, respectively (p = 0.86). The median overall survival (OS) was 14.3 and 29.6 months in the elderly and the non-elderly group, respectively (p = 0.53). Immune related AEs (irAEs) of grade 2 or higher were significantly observed in 50% of the elderly group, comparing with 17% of the non-elderly group (p = 0.048).
The anti-PD-1 inhibitors led to good prognosis for the elderly patients with advanced NSCLC while the rate of irAEs was higher. The follow-up or management of irAE should be careful.
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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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EP1.14-23 - Comparison of Molecular Testing Using Various Specimens for Non-Small Cell Lung Cancers (Now Available) (ID 2767)
08:00 - 18:00 | Author(s): Tetsuya Okano
- Abstract
Background
The effectiveness of various molecular target drugs such as EGFR-TKI for non-small lung cancers came to be shown. So we performed a genetic tests to make plan for suitable therapy individually. For the cases that an operation was carried out for the lung cancer, I inspected the usefulness of the liquid biopsy. The somatic cell variation rate of detection in blood was low, and, in the relatively early non-small-cell lung cancer patient targeted for the operation, the tumor volume was shown in the rule factor when it was. I examined it including the lung cancer case that moved an object as well as an early case this time.
Method
Patients provided written informed consent for use of the samples were participated in this prospective research. EGFR mutation was examined using blood, a liquid cytological specimen, biopsy specimen. These patients was suspected lung cancer and bronchoscopy was performed. We collected blood, the cytodiagnosis specimen using liquid fixed vial for Cellprep and biopsy specimen. I examined EGFR mutations by three kinds of specimens using Cobas EGFR variation detection kit v2.0. We compared results of EGFR mutation,
Result
One-hundred fifty-eight patients were registered to this study. Among those patients, 77 patients with matched set of samples were enrolled to this study. EGFR mutation rates in tissue, cytology, and plasma were 37.7, 29.9 and 16.9 %, respectively. Overall agreement rate of the cytology specimens and the plasma specimens against the tissue samples were 87.0 and 75.3%, respectively. All eightT790M mutation positive cases were perfectly matched between tissue and cytology specimens.
Conclusion
We previously reported that detection of mutations in cfDNA of patients with disease at stage IA or IB or at T2a or lower is difficult. Tumor volume is a determining factor for the feasibility of mutation detection with cfDNA. In this study, advanced lung cancer patients were included. Biopsy specimen were the most feasible sample for detecting mutations. Since high specificities were confirmed in both cytology and plasma specimens, the results are reliable if the mutation results were positive. Choosing cytology or plasma specimens for EGFR testing can be the considerations for the patients who have difficulties in collecting tissue samples in the real world setting.