clinical cases presentation of advanced nsclc patients treated … iii clinical trial phase ii...

21
Clinical cases presentation of advanced NSCLC patients treated with the EGF based therapeutic vaccine Phase III Clinical Trial Phase II Clinical Trial Vaccine-Chemotherapy- Vaccine 4 th CIMAvax EGF Global Meeting November 22-23 th , 2011 Elia Neninger Vinagera M.D. Hernanos Ameijeiras Hospital Ciudad de la Habana

Upload: others

Post on 08-Oct-2020

6 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

Clinical cases presentation of advanced NSCLC patients treated with the EGF based therapeutic vaccine

Phase III Clinical TrialPhase II Clinical Trial Vaccine-Chemotherapy-

Vaccine

4th CIMAvax EGF Global MeetingNovember 22-23th, 2011

Elia Neninger Vinagera M.D.Hernanos Ameijeiras HospitalCiudad de la Habana

Page 2: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

Ensayo Clínico Fase III vacuna EGF

Page 3: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

Ensayo Clínico VQV

Page 4: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

Ensayo Clínico Vacuna EGF Combinación terapéuticaProtocol IIC RD-EC111Paciente TPC--2727Sexo : FemeninoEdad: 37 añosHistoria tabáquica: 30 cigarrillos por día durante 20 añosSintomas: Tosedora habitual, hemoptisis y dolor en hemitórax derechoDiagnostico histologico: Carcinoma de células no pequeñasFecha de diagnóstico:29.05.09Localización: Lóbulo superiorderechoEstadio: IIIB Masa tumoral del lóbulo superior derecho segmento anteriorQue compromete al mediastino compresión de la VCS Adenopatias mediastinales ipsilateralesECOG: 1Fecha de inclusión:05.06.09Fecha de comienzo tto. Con vacuna EGF: 12.06.09Primer ciclo de quimioterapia: 07.07.09

Page 5: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

CASO no. 1 cont….Evaluación después de la Quimioterapia:Remisión parcial: disminución diámetros tumor primario, necrosisDisminución de los síntomas hasta desaparecerEventos adversos:Relacionados vacuna: grado/1Relacionados Quimioterapia: digestivos g/2Mantiene ECOG 0En seguimiento se observa respuesta completa en el tiempo

Page 6: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients
Page 7: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients
Page 8: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

Mayo 2009Supervivencia esperada: 9-10 meses

Page 9: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

EVALUACIÓN-3

/0

/7

/14

/21

/28

CPM

QUIMIOTERAPIA (4-6 CICLOS)

VACUNA EGFVACUNA EGFVACUNA EGF

BSC

Inicio tto:Esquema optimización terapéutica

2 dosis Cimavax EgfQuimioterapia de régimen platino: 4 ciclos

RECIST RP

Page 10: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

Septiembre 2009

Page 11: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

19.03.2010

Page 12: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

Marzo 2010 Tratamiento continuadoRECIST RP

Page 13: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

06.09.2010

No se aprecia tumor

Se considera RC

Page 14: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

Noviembre 2011ECOG 0

Page 15: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

Ensayo Clínico Vacuna EGF Combinación terapéuticaProtocol IIC RD-EC111Paciente JRNY-12Sexo : MasculinoEdad: 79 añosHistoria tabáquica: Exfumador 20 cigarrillos por día durante 51 añosSintomas: Hemoptisis en dos ocasionesDiagnostico histologico: Carcinoma de células no pequeñasFecha de diagnóstico:23.03.09Localización: Lóbulo superior derechoEstadio: IIIB Masa tumoral del lóbulo superior izquierdo segmento posterioren íntimo contacto con la Aorta descendente. Adenopatias mediastinales bilateralesECOG: 1Fecha de inclusión:26.03.09Fecha de comienzo tto. Con vacuna EGF: 03.04.09Primer ciclo de quimioterapia: 06.05.09Radioterapia: 60 Gy

Page 16: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

CASO no. 2 cont….Evaluación después de la Quimioterapia:Remisión parcial: disminución diámetros tumor primarioNo síntomasECOG 0Eventos adversos:Relacionados vacuna: g ½ en las primeras dosisRelacionados quimioterapia: Digestivos g/2, hematológicos g/2En seguimiento se observa mantenimiento de la respuestaMantiene ECOG 0Supervivencia 27,73 meses

Page 17: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

17,03.2009

AL DIAGNÓSTICO

Page 18: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

POST- QUIMIOTERAPIA

Page 19: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

TAC 06.10.2010

Page 20: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

JRNYOCTUBRE 2011

Page 21: Clinical cases presentation of advanced NSCLC patients treated … III Clinical Trial Phase II Clinical Trial Vaccine... · Clinical cases presentation of advanced NSCLC patients

•Respuesta Objetiva•Supervivencia libre de progresión prolongada•Desaparición de síntomas•Calidad de vida óptima