Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
Furthermore, progression free survival and overall survival were not reached.
Conclusion: This quartet chemotherapy was a tolerable and effective regimen,
and we determined the combination of cisplatin at 60mg/m 2 plus 500 mg/m 2
pemetrexed with 150mg erlotinib and 15mg/kg bevacizumab was RD and the
combination cisplatin at 75mg/m 2 was MTD in chemotherapy-naïve advanced
non-squamous NSCLC patients harboring EGFR mutations (UMIN000012536).
Keywords: EGFR, non-small cell lung cancer, maintenance therapy,
combination chemotherapy
POSTER SESSION 3 – P3.02B: ADVANCED NSCLC & CHEMOTHERAPY/TARGETED THERAPY/
IMMUNOTHERAPY
EGFR CLINICAL –
WEDNESDAY, DECEMBER 7, 2016
P3.02B-088 TKI AS FIRST LINE TREATMENT IN ADVANCED NON-
SMALL-CELL LUNG CANCER WITH EGFR MUTATIONS
Inês Guerreiro, Ana Vitor Silva, Ana Rodrigues, Cristina Oliveira, Inés Pousa,
Júlio Oliveira, Isabel Azevedo, Marta Soares
Instituto Portugues de Oncologia Centro Do Porto(Ipo-Porto), Porto/Portugal
Background: Erlotinib and gefitinib are reversible, first-generation, singletarget
tyrosine kinase inhibitors (TKIs) to EGFR/ERBB1 receptor. Testing
for epidermal growth factor receptor (EGFR) mutations is recommended in
patients with nonsquamous non-small cell lung cancer (NSCLC) or NSCLC
not otherwise specified as the mutations are predictive biomarkers of
response to EGFR TKI therapy. We aim to assess the real world effectiveness
of these agents in the setting of the largest Oncologic Centre in Portugal.
Methods: Retrospective analysis of a consecutive series of patients with
stage IIIB/IV NSCLC, EGFR mutated, treated with erlotinib or gefitinib as first
line treatment, since January 2012 at Instituto Português de Oncologia do
Porto, Portugal. Descriptive statistics were used to describe demographics.
Treatment effectiveness was assessed by overall survival (OS) and progression
free survival (PFS) calculated by Kaplan-Meier method and treatment
adverse events (AEs). Results: Of 86 patients with stage IIIB/IV NSCLC,
EGFR mutated, treated with TKI therapy at our center, 64% were female and
the mean age was 65.9 years (range 41-85). The majority of patients were
non-smokers (80.2%) and the most frequent histology was adenocarcinoma
(97.7%). The most commonly found EGFR mutations were deletions in exon
19 and mutation in exon 21. Fifty-one patients (59.3%) received erlotinib as
first line treatment. As of May 2016, 39 patients (45.3%) are still on first line
treatment, with a median follow-up time of 11 months. Median OS was 24
months (CI 95%: 16.7 – 31.3). The overall response rate (ORR) in the erlotinib
group and gefitinib group was 41.2% and 34.3%, respectively, with no
significant difference between groups (p value 0.652). Overall median PFS was
10 months (CI 95%: 7.4 – 12.6), being higher in the erlotinib treatment group (11
versus 7 months). Ten patients in the erlotinib group required dose reductions
because of drug related toxic effects, 9 because of rash grade 3 and 1 because
of hepatotoxicity. One patient in the gefitinib group suspended treatment
because of arthritis. Diarrhea was the second most frequent toxicity related
to TKIs (38.4%). Conclusion: Based on our experience, real world effectiveness
of erlotinib and gefitinib are similar. Patients treated with gefitinib tend to
have less adverse events.
Keywords: advanced non-small-cell lung cancer, Tyrosine kinase inhibitors,
EGFR muations
POSTER SESSION 3 – P3.02B: ADVANCED NSCLC & CHEMOTHERAPY/TARGETED THERAPY/
IMMUNOTHERAPY
EGFR CLINICAL –
WEDNESDAY, DECEMBER 7, 2016
P3.02B-089 TREATMENT OF NSCLC PATIENTS WITH MALIGNANT
PLEURAL EFFUSION HARBORING EXON 19 AND 21 EGFR
MUTATIONS AFTER FIRST-LINE AND SECOND-LINE TKIS
Zhen Zheng 1 , Xiance Jin 1 , Congying Xie 2
1 Radiotherapy and Chemotherapy, The 1St Affiliated Hospital of Wenzhou Medical
University, Wenzhou/China, 2 Radiation Oncology, The 1St Affiliated Hospital of
Wenzhou Medical University, Wenzhou/China
Background: Recent studies demonstrated a significantly increased
frequency of epidermal growth factor receptor (EGFR) gene mutations in
non-small cell lung cancer (NSCLC) patients with malignant pleural effusions
(MPEs). However, the sensitivity of tyrosine kinase inhibitors (TKIs) in NSCLC
patients with MPE for different EFGR mutations was less reported. The
purpose of this study is to investigate the effect of first-line and second-line
EGFR-TKIs in the treatment of NSCLC with MPEs harboring exon 19 deletion
and L858R mutation. Methods: From 2010 to 2015, 203 NSCLC patients with
MPEs harboring EGFR mutation treated with EGFR- TKIs were reviewed.
The efficacy were evaluated with Pearson chi-square or Fisher’s exact tests,
Log-rank test and Cox proportional hazards model. Results: The objective
response rate (ORR) and disease control rate (DCR) for patients treated with
first-line and second-line EGFR-TKIs were 21.9%, 91.4% and 14.7%, 85.3%,
respectively. The overall median PFS and OS of enrolled NSCLC patients with
MPE were 9.3 months (95% Cl, 8.4-10.2 months), 20.9 months (95% Cl, 18.9-
22.9 months) after first-line TKIs, and 7.6 months (95% Cl, 6.6-8.6 months),
15.3 months (95% Cl, 13.6-15.9 months) after second-line TKIs, respectively.
The exon 19 deletion arm had a longer median PFS (9.4 vs. 7.1 months, p=0.003)
and OS (16.8 vs. 13.8 months, p=0.003) compared with the L858R mutation
arm after second-line TKIs. ECOG PS (PFS: P=0.004; OS: P=0.01) and TNM
stage (PFS: P