431P - First-line treatment of advanced nonsquamous non-small cell lung cancer (NSCLC) in China in the era of precision medicine

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
Personalised Medicine
Presenter Xin Zhang
Citation Annals of Oncology (2016) 27 (suppl_9): ix136-ix138. 10.1093/annonc/mdw593
Authors X. Zhang1, Q. Zhou2, Y. Song3, G.Y. Chen4, D.S. Zhong5, Z. Yu6, P. Yu7, Y.P. Zhang8, J.H. Chen9, Y. Hu10, G.S. Feng11, X. Song12, Q. Shi13, L.L. Yang13, P.H. Zhang13, Y. Wu14
  • 1Department Of Respiration And Lung Cancer Comprehensive Treatment Center, Zhongshan Hospital, 200021 - Shanghai/CN
  • 2Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangzhou/CN
  • 3Department Of Respiratory Medicine, Nanjing General Hospital of Nanjing Military Command, Nanjing/CN
  • 4Department Of Internal Medicine I, The Third Clinical School of Harbin Medical University, Harbin/CN
  • 5Department Of Medical Oncology, General Hospital of Tianjin Medical University, Tianjin/CN
  • 6Department Of Oncology, The Affiliated Hospital of Qingdao University, Qingdao/CN
  • 7Department Of Medical Oncology, Sichuan Cancer Hospital, Chengdu/CN
  • 8Department Of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou/CN
  • 9Thoracic Medicine Department I, Hunan Cancer Hospital, Changsha/CN
  • 10Clinical Cancer Center, Chinese PLA General Hospital, Beijing/CN
  • 11Clinical Cancer Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning/CN
  • 12Department Of Respiration Medicine, Shanxi Cancer Hospital, Taiyuan/CN
  • 13China Health Outcomes, Lilly China Drug Development and Medical Affairs Center, 200021 - Shanghai/CN
  • 14Guangdong Lung Cancer Institute, Guangdong General Hospital, 510080 - Guangzhou/CN

Abstract

Background

Over 40% of advanced nonsquamous NSCLC patients in China have an epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) fusion and would benefit from treatment with EGFR or ALK tyrosine kinase inhibitors (TKIs), which are associated with significantly higher response rates and longer progression-free survival. We analysed first-line treatment according to gene aberration test status in advanced nonsquamous NSCLC patients in China (CTONG-1506).

Methods

Our survey of 12 tertiary hospitals in China included advanced nonsquamous NSCLC patients admitted for first-line anti-cancer treatment from August 2015 to March 2016. Data extracted from medical charts for analysis were patient demographics, tumor histologic type, gene aberration test status and results (if performed), and first-line anti-cancer treatment regimen.

Results

The gene aberration test rate for patients (N = 932; median age, 59 years; male, 56%) with advanced nonsquamous NSCLC was 71% and varied with hospital location (Beijing, Shanghai, Guangzhou vs other locations) and type (general vs specialist), and patient residence (urban vs rural). Although 67% of patients with EGFR mutations (mainly in exons 19 or 21; n = 280) received first-line EGFR TKIs, 31% received first-line chemotherapy (chemo.; Table). Most patients with ALK fusions received first-line chemotherapy (56%) or ALK TKIs (35%); 3 patients had co-existing EGFR mutations and received first-line EGFR TKIs (Table). Nearly all patients with negative or unknown gene aberration status (96%) received first-line chemotherapy (Table), of which pemetrexed (66%, 367/554) was the predominant nonplatinum chemotherapy-backbone agent.rn

Table: 431P

rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn
rnGene aberration
n (%)PositiveNegative/ Unknown N = 574
EGFR N = 309ALK N = 48ROS1 N = 1
TKIs207 (67)20 (42)115 (3)
EGFR2053015
ALK11710
VEGFR1000
Chemo.a95 (31)27 (56)0554 (96)
TKIs + Chemo.7 (2)1 (2)05 (1)
EGFR7002
nonEGFR0103
rna

Including bevacizumab-triplet

rn

Conclusions

Results from our survey of tertiary hospitals in China suggest that first-line treatment of advanced nonsquamous NSCLC patients is mostly aligned with the presence or absence of gene aberrations.

Clinical trial indentification

Chinese Thoracic Oncology Group (CTONG) study number 1506

Legal entity responsible for the study

Lilly Suzhou Pharmaceutical Co. Ltd., China

Funding

Lilly Suzhou Pharmaceutical Co. Ltd., China

Disclosure

Q. Shi, L.L. Yang, P.H. Zhang: Employee of Lilly Suzhou Pharmaceutical Co., China. Y-L. Wu: Honoraria: F. Hoffmann-La Roche, Eli Lilly, AstraZeneca, Pfizer. All other authors have declared no conflicts of interest.