Abstract Electronic patient-reported outcome (ePRO) monitoring for patients undergoing cancer chemotherapy may provide qualified and early detection of adverse events or disease-related symptoms, leading to improved patient care. The aim of this study is to examine whether addition of ePRO monitoring to routine medical care contributes to improved overall survival and quality of life of cancer patients undergoing chemotherapy. Patients with unresectable advanced cancers or metastatic/recurrent solid tumors receiving systemic chemotherapy will be randomized to an ePRO monitoring group and a usual care group. The ePRO group will conduct weekly symptom monitoring using an electronic device after study enrollment until the end of the study. Monitoring results will be returned to medical personnel and used as information for patient care. The primary endpoints are overall survival and health related quality of life. The initial target sample size for the study was 1500 patients. However, due to delays in enrollment, the target was readjusted to 500 patients. Enrollment has been completed, and the study is now in the follow-up phase.
7088 Background: This study aimed to investigate the survival outcome of patients with NSCLC who had obtained disease stabilization (SD) with gefitinib treatment and to clarify the effect of continued treatment with gefitinib on prognosis. Methods: We reviewed the clinical records of 365 NSCLC patients who received gefitinib (250 mg/day) in 12 hospitals between 2000 and 2003. Survival was assessed using a landmark analysis and the impact of continued gefitinib treatment on survival was evaluated by considering gefitinib as a time-dependent covariate. Results: In total, 324 (89%) patients (male/female: 67/33%, Ad/others: 74/26%, median age: 67, and ECOG PS 0–1/2–4: 65/35%) were eligible for response analysis. SD occurred in 147 (45%) patients, whereas 71 (22%) patients achieved an objective response. Overall survival (OS) was significantly longer for patients with SD than for those with PD (median OS: 12.1 vs 4.4 months; p<0.0001 by a logrank-test). Gefitinib treatment was discontinued in 54/147 (37%) patients who had SD before disease progression, mainly due to gefitinib-related toxicities including interstitial lung disease(8), infection(7), skin rash(6), nausea/vomiting(4) and hepatotoxicity(3). OS and PFS were longer in those continuing gefitinib treatment compared with those who discontinued treatment (1-year OS: 52.1% vs 36.6%, p=0.08; 1-year PFS: 31.8% vs 5.2%, p=0.0001). Multivariate analysis showed that discontinuation of gefitinib treatment after disease stabilization had a significant impact on progression-free survival in patients with SD (hazard ratio: 1.66, 95%CI=1.07–2.56, p=0.022). Conclusions: Our findings indicate the importance of achieving SD with gefitinib and suggest that continuing gefitinib treatment after SD may prolong progression-free survival. Further studies are required to confirm this effect. No significant financial relationships to disclose.
We herein report a case of the beneficial effect of osimertinib readministration in non-small-cell lung cancer (NSCLC) harboring an epidermal growth factor receptor (EGFR) mutation. A 69-year-old non-smoking woman was diagnosed with advanced NSCLC harboring an EGFR exon19 deletion and T790M. She was treated with osimertinib for two years but eventually acquired resistance. After 1.5 years of salvage chemotherapies, osimertinib was re-administered. She has been effectively and safely treated with osimertinib readministration for over 10 months. A prospective study is warranted to evaluate the efficacy and safety of osimertinib readministration in NSCLC with EGFR mutations.
We report a case with a history of occupational asbestos exposure in which malignant pleural mesothelioma (MPM) was suspected clinically and diagnosed postmortem as pleural involvement of extrapulmonary small cell carcinoma (SCC). An 85-year-old man with a 65 pack-year history of smoking was referred to our hospital in June 2011. The patient had been exposed to asbestos in the iron production industry over the course of 30 years, and an irregular thickening of the right pleura was observed on chest CT at a medical check-up. The patient had a history of chronic hepatitis C and had been undergone transurethral resection for urothelial bladder cancer five times since 2006. Chest CT revealed neoplastic thickening of the right pleura, which had grown over 6 months (figure 1). The CT scan demonstrated bilateral pleural plaques, but no mass-like lesion in other organs, including the lungs, or mediastinal lymphadenopathy. The patient was suspected as having MPM and scheduled for thoracoscopic pleural biopsy, but his general condition worsened rapidly and he …
<p>Prevalence of PD-L1 expression on TC and IC in the PD-L1 BEP. *Includes patients whose tumors had <1% PD-L1 expression on TCs or ICs, but not absolute zero.</p>
