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P2.02-039 Intercalated EGFR and Chemotherapy in Locally Advanced NSCLC with EGFR Mutations: Data on 5 Patients and Clinical Study
January 2017
this cases was 33.5%. In 10 patients with cisplatin plus oral S-1 and concurrent radiation, there were 4 patients (40%) had a down staging of disease with complete lymph node response. In these patients 3 cases are alive without recurrence during 12-32 months follow up. Conclusion: Induction therapy containing cisplatin plus oral S-1 and concurrent radiation seems be feasible and had good response rate. At present, although no improvement in survival was shown for the statistical analysis with induction chemoradiotherapy followed by surgery in cN2/pN2 NSCLC because the number of cases was low, we come to expect improving outcomes in the future. Keywords: Surgery, induction therapy, mediastinal lymph node involvement, non-small cell lung cancer
P2.02-039 Intercalated EGFR and Chemotherapy in Locally Advanced NSCLC with EGFR Mutations: Data on 5 Patients and Clinical Study Topic: Multimodality Treatment
Abstracts
S871
q22) in combination with TKI (Erlotinib d4-20 100 mg/ die p.o. or Gefitinib 250 mg d4-20 of each cycle). PR was achieved after 2 cycles in all patients. All 5 patients were resected, regression grade IIB or III was remarked in mediastinal lymph nodes (#1-4). Pt. #5 had regression grade III. All 5 patients received adjuvant radiotherapy of the mediastinum. One patient died of secondary cancer (rectal cancer) 52 months after diagnosis of NSCLC. 4 pts are alive for 20 to 24 months. Pts 1 and 2 developed isolated CNS mets 8 and 12 months after primary diagnosis which were treated by surgery and/or radiosurgery. Pts 2, 4 and 5 relapsed with distant mets. No resistance mutation was observed and pts are on 1st or 2nd gen. TKI therapy. A phase II trial (NeoIntercal) trial is currently under way in 9 German centers in stages II and III supported by AstraZeneca Pharmaceuticals. Preliminary results of these patients will be presented at the meeting. Conclusion: Intercalated TKI treatment is a promising treatment in patients with EGFR mt+ locally advanced NSCLC that is pursued in a prospective phase II Trial in Germany. CNS mets seems to be the primary site of relapse in most patients. Keywords: EGFR mutation, molecular diagnostic, NSCLC
Frank Griesinger,1 Julia Roeper,1 Anne Lueers,1 Markus Falk,2 Cora Hallas,2 Markus Tiemann2 1Pius Hospital Oldenburg, Oldenburg/Germany, 2Institut Für Hämatopathologie, Hamburg/Germany
P2.02-040 Phase 3 Randomized Low-Dose Paclitaxel Chemoradiotherapy Study Background: EGFR TKI’s are standard of care in pa- for Locally Advanced Non-Small Cell tients with EGFR mt+ NSCLC IV. However, induction Lung Cancer concepts including intercalated TKI / CTx, in locally advanced NSCLC with EGFR mutation including TKI have not been studied extensively. This concept was used as induction regimen in 5 patients with activating EGFR mutations in stages IIIA and IIIB and is now carried on in a phase II study (NeoIntercal). Methods: Patients with EGFR mt+ NSCLC locally advanced were treated on an individual basis, remission induction was measured by RECIST 1.1, regression grading by Junker criteria. Results: 3 female never smokers (pt #1, #3, #5), 59, 62, 62 y.o. 2 male light smokers (pt#2 and #4), 58 and 69 y.o. were diagnosed with with TTF1+ adenocarcinomas of the lung, 2 with exon 21 L858R (#1,2) and 3 with exon 19 deletions (#3,4,5). 4/5 patients (#1-4) carried p53 mutations. Tumor stages were IIIB in pts. #1, 2, 5, IIIA pt. #3, oligometastastic OMD with one organ involved pt. #4. Induction therapy was TKI (Erlotinib or Gefitinib) days -12 to -1, followed by 3 cycles of chemotherapy (Docetaxel 75 mg/m2 d1/Csplatin 50 mg/m2 d 1+2 qd22 or Paclitaxel 200 mg/m2 and Carboplatin AUC 6.0 d1,
Topic: Multimodality Treatment Hongmei Lin,1 Yuhchyau Chen,2 Anhui Shi,1 Kishan Pandya,3 Rong Yu,1 Yannan Yuan,1 Jiancheng Lin,4 Hang Li,5 Yingjie Wang,6 Tingyi Xia,6 Linchun Feng,7 Huimin Ma,1 Jianhao Gang,1 Guangying Zhu1 1Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing/China, 2Radiation Oncology, University of Rochester, Rochester/NY/United States of America, 3Internal Medicine, Div. Hematology/ Oncology, University of Rochester, Rochester/NY/United States of America, 4Radiation Oncology, Fujian Province Cancer Hospital, Fuzhou/China, 5Radiation Oncology, Guizhou Province People’s Hospital, Guiyang/China, 6 Radiation Oncology, Air Force General Hospital, PLA, Beijing/China, 7Radiation Oncology, Chinese PLA General Hospital, Beijing/China Background: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC), but is associated with poor
this cases was 33.5%. In 10 patients with cisplatin plus oral S-1 and concurrent radiation, there were 4 patients (40%) had a down staging of disease with complete lymph node response. In these patients 3 cases are alive without recurrence during 12-32 months follow up. Conclusion: Induction therapy containing cisplatin plus oral S-1 and concurrent radiation seems be feasible and had good response rate. At present, although no improvement in survival was shown for the statistical analysis with induction chemoradiotherapy followed by surgery in cN2/pN2 NSCLC because the number of cases was low, we come to expect improving outcomes in the future. Keywords: Surgery, induction therapy, mediastinal lymph node involvement, non-small cell lung cancer
P2.02-039 Intercalated EGFR and Chemotherapy in Locally Advanced NSCLC with EGFR Mutations: Data on 5 Patients and Clinical Study Topic: Multimodality Treatment
Abstracts
S871
q22) in combination with TKI (Erlotinib d4-20 100 mg/ die p.o. or Gefitinib 250 mg d4-20 of each cycle). PR was achieved after 2 cycles in all patients. All 5 patients were resected, regression grade IIB or III was remarked in mediastinal lymph nodes (#1-4). Pt. #5 had regression grade III. All 5 patients received adjuvant radiotherapy of the mediastinum. One patient died of secondary cancer (rectal cancer) 52 months after diagnosis of NSCLC. 4 pts are alive for 20 to 24 months. Pts 1 and 2 developed isolated CNS mets 8 and 12 months after primary diagnosis which were treated by surgery and/or radiosurgery. Pts 2, 4 and 5 relapsed with distant mets. No resistance mutation was observed and pts are on 1st or 2nd gen. TKI therapy. A phase II trial (NeoIntercal) trial is currently under way in 9 German centers in stages II and III supported by AstraZeneca Pharmaceuticals. Preliminary results of these patients will be presented at the meeting. Conclusion: Intercalated TKI treatment is a promising treatment in patients with EGFR mt+ locally advanced NSCLC that is pursued in a prospective phase II Trial in Germany. CNS mets seems to be the primary site of relapse in most patients. Keywords: EGFR mutation, molecular diagnostic, NSCLC
Frank Griesinger,1 Julia Roeper,1 Anne Lueers,1 Markus Falk,2 Cora Hallas,2 Markus Tiemann2 1Pius Hospital Oldenburg, Oldenburg/Germany, 2Institut Für Hämatopathologie, Hamburg/Germany
P2.02-040 Phase 3 Randomized Low-Dose Paclitaxel Chemoradiotherapy Study Background: EGFR TKI’s are standard of care in pa- for Locally Advanced Non-Small Cell tients with EGFR mt+ NSCLC IV. However, induction Lung Cancer concepts including intercalated TKI / CTx, in locally advanced NSCLC with EGFR mutation including TKI have not been studied extensively. This concept was used as induction regimen in 5 patients with activating EGFR mutations in stages IIIA and IIIB and is now carried on in a phase II study (NeoIntercal). Methods: Patients with EGFR mt+ NSCLC locally advanced were treated on an individual basis, remission induction was measured by RECIST 1.1, regression grading by Junker criteria. Results: 3 female never smokers (pt #1, #3, #5), 59, 62, 62 y.o. 2 male light smokers (pt#2 and #4), 58 and 69 y.o. were diagnosed with with TTF1+ adenocarcinomas of the lung, 2 with exon 21 L858R (#1,2) and 3 with exon 19 deletions (#3,4,5). 4/5 patients (#1-4) carried p53 mutations. Tumor stages were IIIB in pts. #1, 2, 5, IIIA pt. #3, oligometastastic OMD with one organ involved pt. #4. Induction therapy was TKI (Erlotinib or Gefitinib) days -12 to -1, followed by 3 cycles of chemotherapy (Docetaxel 75 mg/m2 d1/Csplatin 50 mg/m2 d 1+2 qd22 or Paclitaxel 200 mg/m2 and Carboplatin AUC 6.0 d1,
Topic: Multimodality Treatment Hongmei Lin,1 Yuhchyau Chen,2 Anhui Shi,1 Kishan Pandya,3 Rong Yu,1 Yannan Yuan,1 Jiancheng Lin,4 Hang Li,5 Yingjie Wang,6 Tingyi Xia,6 Linchun Feng,7 Huimin Ma,1 Jianhao Gang,1 Guangying Zhu1 1Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing/China, 2Radiation Oncology, University of Rochester, Rochester/NY/United States of America, 3Internal Medicine, Div. Hematology/ Oncology, University of Rochester, Rochester/NY/United States of America, 4Radiation Oncology, Fujian Province Cancer Hospital, Fuzhou/China, 5Radiation Oncology, Guizhou Province People’s Hospital, Guiyang/China, 6 Radiation Oncology, Air Force General Hospital, PLA, Beijing/China, 7Radiation Oncology, Chinese PLA General Hospital, Beijing/China Background: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC), but is associated with poor