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Ying Liang
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MA01 - Novel Systemic Treatment in NSCLC (ID 102)
- Event: WCLC 2020
- Type: Mini Oral
- Track: Antibody Drug Conjugates, Novel Therapeutics and Cytotoxics
- Presentations: 1
- Moderators:
- Coordinates: 1/29/2021, 11:45 - 12:45, Scientific Program Auditorium
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MA01.08 - Gemcitabine Plus Capecitabine in Patients With Primary Pulmonary Lymphoepithelioma-Like Carcinoma Previously Treated With Chemotherapy (ID 3283)
11:45 - 12:45 | Presenting Author(s): Ying Liang
- Abstract
- Presentation
Introduction
Primary pulmonary lymphoepithelioma-like carcinoma(PLELC) is a rare and unique pathological subtype of NSCLC. It was found as an Epstein-Barr virus(EBV)-associated epithelial neoplasm. Histologically, PLELC presented as an undifferentiated carcinoma with lymphocytic infiltration, similar to an undifferentiated nasopharyngeal carcinoma(NPC). Because of low incidence of PLELC, the evidence-based treatment guideline was limited. Currently, the treatment strategy of PLELC was following the guidance of NSCLC and platinum-based chemotherapy was the most common first-line regimen. Few studies about salvage chemotherapy in advanced PLELC were reported. Gemcitabine(Gem) was reported to be an active agent in squamous cell NSCLC and also NPC. Ho reported capecitabine (Cap) for pretreated PLELC had promising activity and good tolerability in a small cohort. The combination of gemcitabine/ capecitabine(Gem/Cap) showed active efficacy and favorable toxicity profile in various cancers. Therefore, we conducted this retrospective study to examine the activity and safety of Gem/Cap combination in previously treated advanced PLELC.
Methods
Patients with histologically confirmed PLELC seen at Sun Yat-Sen University Cancer Center between May 2013 to December 2019 were identified. Sixteen patients treated with Gem/Cap in the second-line setting or beyond were included in this analysis. Treatment consisted of i.v. gemcitabine (1000 mg/m2 on days 1 and 8) and oral capecitabine (1000 mg/m2 twice daily on days 1–14) every 3 weeks.
Results
Characteristics of the patients were shown in Table 1 . There were 5(31.3%) patients who had received one prior chemotherapy regimen while the remaining patients received 2–4 prior chemotherapy regimens. Four patients had ever received gemcitabine/ platinum or gemcitabine/docetaxel as prior chemotherapy, but no patient had ever exposed to Gem/Cap regimen. As of the last follow-up, 16 patients received a total of 89 (median: 5.5, range: 2-12) cycles of Gem/Cap therapy. All patients were evaluable for response. There were 0 CR, 8 (50.0%) PR, 6（37.5%) SD and 2 (12.5%) patients with PD after at least 2 cycles. The ORR was 50% and DCR was 87.5%. At a median follow-up of 15.9 months, the median PFS was 8.8 months (95% CI: 5.6 -12.0 months). The median OS was not reach at the time of data cut-off. All patients were evaluated for toxicity. The most common AE at any grade was neutropenia (31.25%). The grade 3-4 neutropenia was 6.25%. There was no treatment-related death.
Table 1: Patients' characteristics
ConclusionVariable Data Median age (range), years 46(35-65) Gender Male 8(50.00%) Female 8(50.00%) WHO Performance Status 0 9(56.25%) 1 7(43.75%) History of smoking Yes 6(37.50%) No 10(62.50%) Number of prior chemotherapy 1 5 (31.25%) 2 5 (31.25%) 3 3 (18.75%) 4 3 (18.75%) Cycles of Gemcitabine/Capcitabine combination Median 5.5 Range 2-12
This retrospective study has shown good efficacy and well tolerability of gemcitabine plus capecitabine combination as salvage chemotherapy in PLELC patients previously treated with chemotherapy.
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