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E.Y. Kim
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P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.01-041 - Prognostic Significance of CT Emphysema Score in Patients with Advanced Squamous Cell Carcinoma of the Lung (ID 680)
09:30 - 17:00 | Author(s): E.Y. Kim
- Abstract
Background:
Although the contribution of emphysema to lung cancer risk has been recognized, no study has focused the prognostic impact of CT emphysema score for advanced stage of lung cancer. The aim of our study was to analyze the prognostic value of CT emphysema score in patients with advanced squamous cell carcinoma of the lung (SCCL).
Methods:
We analyzed 84 consecutive patients with advanced stage (stage IIIB and IV) of SCCL who underwent palliative chemotherapy. The severity of emphysema was semi-quantitatively scored using baseline chest CT images according to the Goddard scoring system, ranging from 0 to 24. Data on clinical characteristics and survival were retrospectively collected. Survival was estimated by the Kaplan-Meier method and compared with the log-rank test. A multivariable Cox proportional hazard model was used to identify prognostic factors.
Results:
Most patients were male (89%) and current/ex-smokers (90%). The median CT emphysema score was five (range, 0 to 22). In univariable analysis, patients with higher CT emphysema score (> 6) showed a trend toward poor survival (6.3 months vs. 11.4 months in those with lower score, p=0.076). In the multivariable model, higher CT emphysema score was a significant independent prognostic factor for poor survival (HR,1.85; 95% CI, 1.14 to 3.00; p=0.012) along with response to first-line therapy (p=0.001) and second-line therapy (p<0.001).
Conclusion:
The CT emphysema score is significantly associated with poor prognosis in patients with advanced SCCL.
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P1.07 - Poster Session/ Small Cell Lung Cancer (ID 221)
- Event: WCLC 2015
- Type: Poster
- Track: Small Cell Lung Cancer
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.07-008 - Preliminary Results from a Phase Ib/II Trial of Belotecan plus Ifosfamide in Patients with Extensive-Stage Small-Cell Lung Cancer (ID 1325)
09:30 - 17:00 | Author(s): E.Y. Kim
- Abstract
Background:
Belotecan is a novel camptothecin analogue, topoisomerase I inhibitor. Belotecan, alone or in combination with cisplatin, has shown activity in small cell lung cancer. The objective of the phase Ib part was to determine the maximum tolerated dose (MTD) and safety of belotecan plus ifosfamide in patients with extensive-stage small-cell lung cancer.
Methods:
Patients with age ≥ 18 years, no previous chemotherapy, measurable disease, ECOG PS 0-2, and adequate organ function were eligible. The phase Ib portion of the trial is a conventional 3+3 dose-escalation design. The following dose levels (belotecan/ifosfamide, mg/m[2]) were explored: 0.5 x 4d/1200 x 2d (level 1), 0.5 x 4d/1000 x 3d (level 2, starting dose), 0.5 x 4d/1000 x 4d (level 3), 0.5 x 5d/1000 x 4d (level 4), and 0.5 x 5d/1000 x 5d (level 5) every 21 days.
Results:
Here we report the phase Ib portion of the trial. Thirteen patients were enrolled and completed at least one cycle. The median age is 68 years (range, 48-77). ECOG PS was 0/1/2:1/6/6, respectively. A total of 53 cycles (median, 5; range, 1-6) of chemotherapy were administered. The MTD was belotecan 0.5 mg/m[2] on days 1-4 in combination with ifosfamide 1000 mg/m[2] on days 1-4 (level 3). Three patients experienced dose-limiting toxicities; death from neutropenic sepsis and grade 3 fatigue at dose level 4, and febrile neutropenia at dose level 3. The most frequent grade 3-4 toxicities were myelosuppression, including neutropenia (54%), anemia (23%), and febrile neutropenia (23%). Eleven patients were evaluable for response and 9 (82%) had partial responses.
Conclusion:
The combination of bleotecan and ifosfamide is feasible and active. The recommended phase II dose is belotecan 0.5 mg/m[2] on days 1-4 and ifosfamide 1000 mg/m[2] on days 1-4 of a 21-day cycle. The phase II trial is currently ongoing. Clinical trial information:NCT01784107.
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P2.07 - Poster Session/ Small Cell Lung Cancer (ID 222)
- Event: WCLC 2015
- Type: Poster
- Track: Small Cell Lung Cancer
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.07-017 - Body Composition Analysis Using Computed Tomography in Patients with Small Cell Lung Cancer (ID 2542)
09:30 - 17:00 | Author(s): E.Y. Kim
- Abstract
Background:
Although the clinical significance of body composition has been recognized as associated with performance status and prognoses for solid tumors, no study has specifically evaluated baseline body composition in detail using computed tomography (CT) images for patients with small cell lung cancer (SCLC).
Methods:
We analyzed skeletal muscle mass and fat mass in 150 patients with pathologically proven SCLC between January 2010 and November 2014 in our institution. Cross-sectional areas of skeletal muscle (Hounsfield unit, HU ranges -29 to 150) and fat tissue (HU, -190 to -30) were measured on the level of 3rd lumbar vertebra using the baseline CT images. Data on clinical characteristics were retrospectively collected.
Results:
Mean age was 69 ± 9 years (85.3% were male). At the time of diagnosis, mean body mass index (BMI) was 22.1, with 40.7% of patients being overweight or obese (BMI ≥ 23). Only 16.7% overall were underweight as conventionally understood (BMI < 18.5). The overall prevalence of severe muscle depletion (sarcopenia) was 53.3% and was present in patients in all BMI categories (84.0% in underweight patients, 45.2% in overweight and obese patients). A much higher proportion of men (60.2%) than women (13.6%) met the criteria of sarcopenia.
Conclusion:
Wasting of skeletal muscle is a prominent feature of patients with small cell lung cancer, despite normal or heavy body weights.
