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P1.30: Clinical Efficacy and Tolerability of Bevacizumab in Elderly Patients With Advanced Non-Squamous NSCLC
S200
Medicine, BioTheranostics, and Genoptix). For LBx analysis, only Guardant 360 test was considered. The Guardant 360 test assays a panel of 70 genes (see Fig. 1) to identify genomic alterations in cancer-associated somatic variants with high sensitivity. Cell-free DNA (cfDNA) is extracted from plasma and genomic alterations are analyzed by massively parallel sequencing of amplified target genes. Results: The distribution by gender was 56 female patients and 25 males; median age 71 (range, 27-99). 65/81 pts (80%) had at least 1 genomic alteration by LBx (range, 1-10). Most common abnormalities found in LBx were: TP53 (32 pts), EGFR (27 pts), NF1 (16 pts), KRAS (11 pts), MET (10 pts). From this 65 pts with + LBx results, 49 pts (75%) had tumor tissue MPRs for comparison. Major reason for lack of tumor tissue MPRs: insufficient tumor (18/81; 22%). For comparison between the 2 modalities, we considered all pts with available results in both tests; hence, 63 pts were used to compare TBx with LBx. 33 pts out of 63 (52%) had at least 1 similar genomic abnormality or MPRs found in both TBx and LBx. Most of the concordance was in EGFR alterations (17/22; 77%). LBx caught 10 additional EGFR genomic aberrations not being identified by TBx (a total of 27 EGFR genomics aberrations were identified in LBx). 14 EGFR found in LBx were actionable; 3/10 of mutant EGFR found only in LBx were actionable. Conclusion: LBx using Guardant 360 evaluation offers an alternative to identify genomic alterations including actionable mutations; still, insufficient tumor is the major reason for lacking of tumor MPRs and more advances to obtain TBx are needed. Our cohort had 48% concordance between LBx and TBx. Keywords: liquid biopsy, lung cancer, biomarkers, cell free DNA
P1.30 Clinical Efficacy and Tolerability of Bevacizumab in Elderly Patients With Advanced Non-Squamous NSCLC
Journal of Thoracic Oncology
Vol. 11 No. 10S
lung cancer (NSq-NSCLC) stratified by age have been analyzed in two retrospective studies. First analysis was from ECOG 4599 (pts < or 70 years old) and second analysis was a pooled analysis between ECOG 4599 and PointBreak clinical trials. In the later, pts were grouped by age: < 65, 65-74, 70-74, < 75, and 75 years. Carboplatin/Paclitaxel (C/P) + Bev was associated with significant increases in overall survival (OS) relative to C/P alone in all groups but 75 years old. There were more adverse events (AEs) in pts < or 75 years old in the C/P/Bev group vs C/P alone. Method: Using our electronic database, we used three variables: lung cancer, 75 years old, and Bev. In the last 67 months (August 2010-March 2016), we found 27 pts with these characteristics. All patients had NSqNSCLC and all patients were treated with the attempt to initiate maintenance therapy (MTX) with Bev alone or doublet MTX therapy with pemetrexed (Pem) and Bev or any combination with Bev. We analyzed safety and tolerability as well as number of Bev cycles given to this cohort of pts. Results: Twenty pts were females and 7 were males; all pts had adenocarcinoma histology. The initial systemic therapy was distributed as follow: 14 pts received C/ Pem/Bev and 13 pts received C/P/Bev. Maintenance (MTX) was either Bev alone or Pem/Bev. Median age was 77 years old (range, 75-86). Most common AEs were: fatigue (n¼7), vomiting (n¼2), and diarrhea (n¼2). Serious AEs (SAEs) requiring stop Bev were: hypertensive crisis (n¼1), gastrointestinal perforation (secondary to duodenal ulcer; n¼1) and grade 3 epistaxis (n¼1). No embolic events, nephrotic syndrome, fistula perforation, RPLS, and pulmonary hemorrhage were reported in this cohort. A total of 17 pts (63%) received MTX; 6 pts did not move into MTX phase and there are 4 pts who are still on initial chemotherapy (CTX) phase. Median cycles of MTX therapy using Bev or Pem/Bev was 7 (range, 4-42); median total of Bev cycles including initial therapy was 9 (range, 2-48). Median progression-free survival (PFS) was 8.3 months.
Edgardo S. Santos,1 Lilibeth Castillero2 1Oncology, Lynn Cancer Institute, BOCA RATON/FL/UNITED STATES OF AMERICA, 2Medicine, University of Panama, Panama/ PANAMA
Conclusion: In our 27 pts older than 75 years old, we found 3 SAEs. Our pts had good ECOG PS (0-1); 12 pts (44%) had 1 comorbid condition. Median PFS was 8.3 months in this cohort; PFS reported in ECOG 4599 was 6.2 months and in Pointbreak study was 6.0 months for C/Pem/Bev and 5.6 C/P/Bev groups. With careful clinical evaluation, our experience indicates that Bev can be offered to elderly pts. Bev was well tolerated in this cohort of patients older than 75 years.
Background: The effect of bevacizumab (Bev) in patients (pts) with metastatic non squamous non-small cell
Keywords: Angiogenesis, elderly patient, bevacizumab, lung cancer
Track: Advanced NSCLC
Medicine, BioTheranostics, and Genoptix). For LBx analysis, only Guardant 360 test was considered. The Guardant 360 test assays a panel of 70 genes (see Fig. 1) to identify genomic alterations in cancer-associated somatic variants with high sensitivity. Cell-free DNA (cfDNA) is extracted from plasma and genomic alterations are analyzed by massively parallel sequencing of amplified target genes. Results: The distribution by gender was 56 female patients and 25 males; median age 71 (range, 27-99). 65/81 pts (80%) had at least 1 genomic alteration by LBx (range, 1-10). Most common abnormalities found in LBx were: TP53 (32 pts), EGFR (27 pts), NF1 (16 pts), KRAS (11 pts), MET (10 pts). From this 65 pts with + LBx results, 49 pts (75%) had tumor tissue MPRs for comparison. Major reason for lack of tumor tissue MPRs: insufficient tumor (18/81; 22%). For comparison between the 2 modalities, we considered all pts with available results in both tests; hence, 63 pts were used to compare TBx with LBx. 33 pts out of 63 (52%) had at least 1 similar genomic abnormality or MPRs found in both TBx and LBx. Most of the concordance was in EGFR alterations (17/22; 77%). LBx caught 10 additional EGFR genomic aberrations not being identified by TBx (a total of 27 EGFR genomics aberrations were identified in LBx). 14 EGFR found in LBx were actionable; 3/10 of mutant EGFR found only in LBx were actionable. Conclusion: LBx using Guardant 360 evaluation offers an alternative to identify genomic alterations including actionable mutations; still, insufficient tumor is the major reason for lacking of tumor MPRs and more advances to obtain TBx are needed. Our cohort had 48% concordance between LBx and TBx. Keywords: liquid biopsy, lung cancer, biomarkers, cell free DNA
P1.30 Clinical Efficacy and Tolerability of Bevacizumab in Elderly Patients With Advanced Non-Squamous NSCLC
Journal of Thoracic Oncology
Vol. 11 No. 10S
lung cancer (NSq-NSCLC) stratified by age have been analyzed in two retrospective studies. First analysis was from ECOG 4599 (pts < or 70 years old) and second analysis was a pooled analysis between ECOG 4599 and PointBreak clinical trials. In the later, pts were grouped by age: < 65, 65-74, 70-74, < 75, and 75 years. Carboplatin/Paclitaxel (C/P) + Bev was associated with significant increases in overall survival (OS) relative to C/P alone in all groups but 75 years old. There were more adverse events (AEs) in pts < or 75 years old in the C/P/Bev group vs C/P alone. Method: Using our electronic database, we used three variables: lung cancer, 75 years old, and Bev. In the last 67 months (August 2010-March 2016), we found 27 pts with these characteristics. All patients had NSqNSCLC and all patients were treated with the attempt to initiate maintenance therapy (MTX) with Bev alone or doublet MTX therapy with pemetrexed (Pem) and Bev or any combination with Bev. We analyzed safety and tolerability as well as number of Bev cycles given to this cohort of pts. Results: Twenty pts were females and 7 were males; all pts had adenocarcinoma histology. The initial systemic therapy was distributed as follow: 14 pts received C/ Pem/Bev and 13 pts received C/P/Bev. Maintenance (MTX) was either Bev alone or Pem/Bev. Median age was 77 years old (range, 75-86). Most common AEs were: fatigue (n¼7), vomiting (n¼2), and diarrhea (n¼2). Serious AEs (SAEs) requiring stop Bev were: hypertensive crisis (n¼1), gastrointestinal perforation (secondary to duodenal ulcer; n¼1) and grade 3 epistaxis (n¼1). No embolic events, nephrotic syndrome, fistula perforation, RPLS, and pulmonary hemorrhage were reported in this cohort. A total of 17 pts (63%) received MTX; 6 pts did not move into MTX phase and there are 4 pts who are still on initial chemotherapy (CTX) phase. Median cycles of MTX therapy using Bev or Pem/Bev was 7 (range, 4-42); median total of Bev cycles including initial therapy was 9 (range, 2-48). Median progression-free survival (PFS) was 8.3 months.
Edgardo S. Santos,1 Lilibeth Castillero2 1Oncology, Lynn Cancer Institute, BOCA RATON/FL/UNITED STATES OF AMERICA, 2Medicine, University of Panama, Panama/ PANAMA
Conclusion: In our 27 pts older than 75 years old, we found 3 SAEs. Our pts had good ECOG PS (0-1); 12 pts (44%) had 1 comorbid condition. Median PFS was 8.3 months in this cohort; PFS reported in ECOG 4599 was 6.2 months and in Pointbreak study was 6.0 months for C/Pem/Bev and 5.6 C/P/Bev groups. With careful clinical evaluation, our experience indicates that Bev can be offered to elderly pts. Bev was well tolerated in this cohort of patients older than 75 years.
Background: The effect of bevacizumab (Bev) in patients (pts) with metastatic non squamous non-small cell
Keywords: Angiogenesis, elderly patient, bevacizumab, lung cancer
Track: Advanced NSCLC