View Abstract

A4687 - Thyroid Transcription Factor-1 Expression Predicts the Efficacy of Bevacizumab Added on Platinum Drugs and Pemetrexed Chemotherapy in Non-Squamous Non-Small-Cell Lung Cancer
Author Block: A. Takeuchi1, T. Oguri1, Y. Yamashita2, K. Sone1, S. Fukuda1, O. Takakuwa3, K. Maeno1, T. Asano1, Y. Kanemitsu1, H. Ohkubo1, M. Takemura1, Y. Ito1, A. Niimi1; 1Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Science, Nagoya, Japan, 2Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Science, Nagoya, Japan, 3Education and Research Center for Advanced Medicine, Nagoya City University Graduate School of Medical Science, Nagoya, Japan.
Rationale; Addition of antiangiogenic agent, bevacizumab, on platinum drug combined therapy is one of the standard chemotherapy for advanced non-squamous non-small-cell lung cancer (NS-NSCLC). However, the predictive biomarker of effectiveness of bevacizumab is still unclear. Recently it was reported that thyroid transcription factor 1 (TTF-1), which is used as the diagnostic marker of lung adenocarcinoma in clinical practice, reprogrammed angiogenic activities through the proangiogenic factor, vascular endothelial growth factor (VEGF). Therefore, we examined whether TTF-1 expression in tumor tissue was predictive marker of bevacizumab added on platinum drugs and pemetrexed chemotherapy in NSCLC. Method; We retrospectively reviewed 118 advanced NS-NSCLC patients treated with pemetrexed and platinum derivatives alone (Bev (-)) or with bevacizumab (Bev (+)). We inspected the relationship between expression of TTF-1 and clinical benefit of bevacizumab addition: changes of response rate (RR), progression free survival (PFS), and overall survival (OS). Result; The median age of patients was 67 years old (37-79). Histological features were adenocarcinoma (n=114) and large cell carcinoma (n=4). Twenty-six patients had epidermal growth factor receptor (EGFR) mutation and 3 patients had anaplastic lymphoma kinase (ALK) translocation. Thirty-nine patients treated with cisplatin and 79 patients treated with carboplatin. In 92 TTF-1 positive patients, RR in Bev (+) group was significantly higher than in Bev (-) group (51.4% vs 27.3%; p=0.027). Bev (+) group also had longer PFS than Bev (-) group (median PFS, 216 days vs 137 days; p=0.012). But OS was not significant difference between Bev (+) and Bev (-) groups (median OS, 646 days vs 503 days; p=0.471). On the other hand, in 26 TTF-1 negative patients, there were no significant differences between Bev (+) and Bev (-) group for RR (28.6% vs 21.1%; p=1), PFS (median PFS, 124 days vs 131 days; p=0.374), and OS (median OS, 351 days vs 354.5 days; p=0.543) respectively. Conclusion; Expression of TTF-1 may be able to identify the group of NS-NSCLC patient who has a benefit added of bevacizumab on platinum drugs and pemetrexed chemotherapy.