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Yangyang Cai
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FP10 - Small Cell Lung Cancer/NET (ID 231)
- Event: WCLC 2020
- Type: Posters (Featured)
- Track: Small Cell Lung Cancer/NET
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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FP10.05 - A Prospective Phase II Study of Apatinib Plus Chemotherapy for Pretreated Patients With Advanced Small Cell Lung Cancer (ID 2045)
00:00 - 00:00 | Author(s): Yangyang Cai
- Abstract
Introduction
Small-cell lung cancer (SCLC), which accounts for ∼15% of all lung cancers, is characterised by its rapid proliferation. The clinical outcomes of second-line and above treatments are unsatisfactory, resulting in a median progression-free survival (PFS) of less than 3 months. There is currently none targeted drugs or new chemotherapeutic drugs that can achieve breakthroughs in advanced SCLC. This study aims to observe whether apatinib in combination with chemotherapy can be a new choice for pretreated patients with advanced SCLC. This clinical trial has presented initial results in 2019 WCLC abstract 1788. This has updated the new data.
Methods
This is a prospective, single-center, single-arm clinical study designed to evaluate the efficacy and safety of apatinib plus chemotherapy for second-line and above treatment of advanced SCLC ((NCT03547804)). The dose of apatinib was 500mg per day in the initial protocol, and the treatment plan was adjusted due to tolerance of patients later and lower dose of apatinib 250mg once daily was applied. The dose of apatinib could be further reduced to 250mg every other day if the patient was observed with a grade 3/4 adverse effect. Chemotherapeutic agents were limited to irinotecan or docetaxel alone. The primary endpoint was the progression-free survival (PFS). The secondary endpoints included overall survival (OS), disease control rate (DCR), objective response rate (ORR), and adverse events (AEs).
Results
31 patients were enrolled from March 2018 to Oct 2019. 28 patients were available for response evaluation. The ORR and DCR were 25.00% (7/28) and 100% (28/28), respectively. The median PFS and OS were 7.43 months and 12.50 months, respectively (Fig 1a-1b). For subgroup analyses, we found that limited-stage disease had a longer PFS comparied with that of extensive-stage disease (9.17m vs 4.33m, P=0.0013) (Fig 1c). There were no significant differences in efficacy in subgroups of different initial dose (500mg vs 250mg) and age (＜60y vs ≥60y). The most common treatment-related AEs were neutropenia, thrombocytopenia, hypertension, hand-foot syndrome, proteinuria, diarrhea, abnormal liver function and mucitis. However, the incidence of grade Ⅲ-Ⅳ adverse reactions was lower and the patients had a better tolerance with an initial dose of apatinib 250mg plus chemotherapy.
Conclusion
Apatinib plus single agent chemotherapy showed a promising efficacy and a good tolerance in patients with pretreated SCLC. Especially, apatinib 250mg per day was recommended in this clinical trial.
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P02 - Diagnostics and Interventional Pulmonology (ID 110)
- Event: WCLC 2020
- Type: Posters
- Track: Diagnostics and Interventional Pulmonology
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P02.25 - Coexistence of Invasive Adenocarcinoma, Minimally Invasive Adenocarcinoma and Atypical Adenomatous Hyperplasia: A Case Report (ID 1726)
00:00 - 00:00 | Author(s): Yangyang Cai
- Abstract
Introduction
Multiple small nodular lung cancer (MSLC) refers to multiple tumor nodules on the same or different lobes of the lungs. These nodules are affected by the same germline characteristics and environmental exposure factors that occur simultaneously in one individual. Invasive adenocarcinoma (inv ADC), minimally invasive adenocarcinoma (MIA) and atypical adenomatous hyperplasia (AAH) are regarded as the “three-steps” in the evolution of lung adenocarcinoma.
Methods
A fifty-year-old Asian female patient without a history of smoking was hospitalized due to three ground-glass nodules (GGNs) in the right upper lobe of the lung, which were detected in March 2017. Three nodules revealed by chest CT were each pathologically diagnosed as ADC, MIA and AAH. To further confirm the correlations and differences among these types, we performed whole-exome sequencing on the three lesions followed by a comparative analysis at the genetic level to determine the major genes that may play an important role in the progression of these “three-steps” in lung adenocarcinoma.
Results
The TMB of the three lesions was relatively low, especially in AAH.(Fig 2C) The three lesions were found to share a common gene (BAGE2).(Fig 2B) We found that MAP3K14, MAP2K1, and EGFR, which are three major genes of the EGFR-MAPK pathway, may play an important role in AAH, MIA and inv ADC, respectively.(Fig 2D) The C>T alteration was the primary change observed in the three nodules of the patient. C>A was increased in the ADC nodule and decreased in the MIA nodule, but was rare in AAH.(Fig 2E, F)
Conclusion
We found that MAP3K14, MAP2K1, and EGFR were three dominant factors that exist as part of “three-steps” and that might act as new specific targets for the treatment of this disease type. However, the relationship among MAP2K1, MAP3K14 and EGFR still requires more verification in more samples.
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P86 - Targeted Therapy - Clinically Focused - New Target (ID 263)
- Event: WCLC 2020
- Type: Posters
- Track: Targeted Therapy - Clinically Focused
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P86.23 - Clinical Efficacy Analysis of Apatinib as a Second-Or Further-Line Treatment in Patients With Advanced NSCLC (ID 2072)
00:00 - 00:00 | Author(s): Yangyang Cai
- Abstract
Introduction
Angiogenic agents play an important role in the therapeutic strategy for advanced NSCLC. Apatinib is a novel tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor-2. The purpose of this study was to collect data on the clinical efficacy and side effects of oral apatinib as a second-or further-line in patients with advanced NSCLC in the first hospital of Jilin University.
Methods
A total of 43 patients with advanced NSCLC who were hospitalized in the Cancer Center of the First Hospital of Jilin University from January 1, 2017 to December 31, 2018 were enrolled. This study included patients whose initial dose was apatinib 500mg per day. Statistical analysis was performed using the SPSS19.0 system. The Kaplan-Meier method was used for survival analysis and the COX proportional hazard model was used for single factor analysis. The difference was statistically significant at p<0.05.
Results
Among all patients, the objective response rate (ORR) is 11.6% and the disease control rate (DCR) is 72.1%. The median progression-free survival (PFS) was 3.7 months. The ORR and DCR of 30 patients with Eastern Cooperative Oncology Group (ECOG) score of 0-1 were 16.7% and 83.3%, respectively, and the median PFS was 5.4 months (95% CI 3.1-7.7 months). The ORR and DCR of 13 patients with ECOG score of 2 were 0 and 4.6%, respectively, and the median PFS was 2.7 months (95% CI 2.1-3.3 months). The difference between the two groups was statistically significant (P=0.012). The most common treatment-related AEs were hypertension (48.8%), hand-foot syndrome (39.5%), diarrhea was (18.6%), nausea and vomiting (18.6%), and the incidence of grade 3 to 4 adverse reactions was 9.3%.
Conclusion
Apatinib is convenient, effective and safe in the treatment of advanced NSCLC patients, and the incidence of adverse reactions is low and controllable. ECOG score is the influencing factor of median PFS. For patients with ECOG score of 0-1, oral apatinib 250mg per day therapy can show a better therapeutic effect.
