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Yu-ming Jia
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P76 - Targeted Therapy - Clinically Focused - EGFR (ID 253)
- 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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P76.29 - Clinical Observation of EGFR-TKI Combined With 89Sr in the Treatment of Non-Small Cell Lung Cancer With Osteoblastic Reaction (ID 1523)
00:00 - 00:00 | Presenting Author(s): Yu-ming Jia
- Abstract
Introduction
Osteoblastic reaction (OR) is an effective manifestation of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in the treatment of bone metastasis. Strontium-89(89Sr) is an effective treatment for multiple bone metastases. The purpose of this study was to observe the efficacy and safety of EGFR-TKI combined with 89Sr in the treatment of non-Small cell lung cancer (NSCLC) patients with osteoblastic reaction.
Methods
Patients who met the following conditions from June 2015 to June 2018 in the Second People's Hospital of Yibin were retrospectively collected: NSCLC patients with multiple osteolytic bone metastases initially and then were treated with EGFR-TK effectively.All patients were initially treated with EGFR-TKI, and CT imaging was used to determine whether osteoblastic reaction occurred. Among them, patients with osteoblastic reaction were divided into EGFR-TKI monotherapy group (non-combined group) and EGFR-TKI combined with 89Sr group (combined group).To observe the probability of osteoblastic reaction incidence(ORI) and median osteoblastic reaction time(MORT) after EGFR-TKI treatment, and to compare bone progression-free survival(BPFS), profession-free survival (PFS) and side effects between the combined group and the non-combined group.
Results
Thirty seven patients were included in this study.Among them, 25 cases had osteoblastic reaction, and the osteoblastic reaction incidence was 67.57%. The median osteoblastic reaction time was 54 days (range, 29-86 days). There were 10 cases in the combined group and 15 cases in the uncombined group. Compared with the uncombined group, BPFS (17.60months vs 12.70months, P=0.039), PFS (12.23 months vs 11.50months, P=0.136)and BPFS were statistically significant. There were no grade 3 or above level adverse events in both groups.
Conclusion
The combination of EGFR-TKI and 89Sr after osteoblastic reaction induced by EGFR-TKI can delay the recurrence of bone metastasis, which may prolong the progression free survival time of patients. The side effects of the combination were tolerable. It may be worth expanding the sample for further study.
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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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P86.17 - Continuous Administration of Low-Dose Apatinib Combined With WBRT for Non-Small Cell Lung Cancer With Symptomatic Brain Metastases (ID 1272)
00:00 - 00:00 | Presenting Author(s): Yu-ming Jia
- Abstract
Introduction
Symptomatic multiple brain metastases occur in non-small cell lung cancer patients (NSCLC) who are without driver mutations or are resistant to epidermal growth factor tyrosine kinase (EGFR-TKI) are often associated with a unfavourable prognosis. Whole brain radiation therapy (WBRT) which comes with many complications and unsatisfactory effects, is the only option for the treatment. Previous studies have shown that antiangiogenesis combined with WBRT can improve efficiency and prolong survival. This study evaluated the effects and safety of apatinib combined with WBRT in NSCLC patients with symptomatic multiple brain metastases.
Methods
We performed a retrospective review of 13 patients with multiple brain metastases from NSCLC treated with apatinib (125mg or 250mg, QD, oral) and WBRT. Intracranial objective response rate (IORR), peritumoral edema volumetric measurement, karnofsky performance status (KPS) and adverse events (AEs) were evaluated. Median intracranial progression-free survival (mIPFS) and median overall survival (mOS) were also analyzed.
Results
Thirteen patients with NSCLC who were diagnosed with symptomatic multiple brain metastases received apatinib combined with WBRT were inclued, including 1 lung squamous cell carcinoma (LSCC) and 12 lung adenocarcinoma. Six patients were EGFR-TKI resistant, while the other six were without driver mutations. Until the last follow-up in March 2020, 5 patients died, and 8 patients were still alive. The IORR was 84.6% (11/13) and intracranial disease control rate (IDCR) was 100% (13/13). The median edematous volume decreased by 87.96% (range 42% to 98%, p < 0.001), the average KPS score increased from 62.31 ± 12.35 to 82.31 ± 9.27 (t = -8.83, P < 0.001). The mIPFS was 6.7 months [95% confidence interval (CI): 4.3 - 9.1], and the mOS was 8.8months (95% CI: 5.8 - 11.8). The most commonly adverse events of apatinib combination WBRT included grade 1/2 fatigue (3, 23.1%), inappetence (3, 23.1%), hypertension (2, 15.4%) and leukopenia (2, 15.4%), and no grade 3/4 AEs were observed.
Conclusion
This retrospective study suggests that NSCLC patients with multiple brain metastases treated with apatinib combined with WBRT, achieved encouraging therapeutic effects, showed a significant reduction in tumor size and peritumoral edema, enjoyed an improved KPS score and experienced prolonged survival time. Apatinib combined with WBRT is well tolerated and may be a potential choice for relapsed or drug-resistant advanced NSCLC patients with symptomatic multiple brain metastases.
