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M. Majem
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P1.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 224)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.08-008 - Efficacy of Palliative Chemotherapy in Malignant Pleural Mesothelioma from Spanish BEMME Database. The Spanish Lung Cancer Group (SLCG) (ID 2356)
09:30 - 17:00 | Author(s): M. Majem
- Abstract
Background:
Palliative chemotherapy with cisplatin and antifolate (pemetrexed or raltitrexed) conferred a median overall survival of 12 months with a response rate of 24% to 43% in malignant pleural mesothelioma (MPM) patients. BEMME (Base Epidemiológica Mesotelioma Maligno en España) is an observational and retrospective study sponsored by the Spanish Lung Cancer Group that aimed to characterize the patient’s and tumor’s features as well as the treatment modalities outcomes of patients diagnosed with mesothelioma in Spain.
Methods:
Clinical records of patients with malignant pleural mesothelioma were retrospectively reviewed to collect epidemiological and survival data into an electronic and anonymous database. Thirty-five Spanish hospitals participated in the project and 538 MPM patients were included in the BEMME database. Here we present a descriptive analysis of MPM patients (stage III and IV) treated with palliative chemotherapy.
Results:
From January 2008 to December 2013, 297 of 538 patients (p) (55%) with MPM were treated with palliative chemotherapy. Most patients were males (79%), aged between 60-70y (40%), and 60% had a performance status 1 at diagnosis. No exposure to asbestos was reported in 54% of patients. Epithelioid was the most frequent histological subtype (66%), followed by sarcomatoide (12%), biphasic (9%) and not specified (14%). In stage IV, the most frequent metastatic site was lung (35%). Among patients who received chemotherapy, 55% were treated with palliative intent and reached a disease control rate (CR+PR+SD) of 62%. Platinum plus pemetrexed was the most common schedule used as a palliative treatment, without differences in ORR according to platinum-based agent used (Cisplatin: 36% vs. Carboplatin: 32%). A total of 61 of the 297p (21%) received maintenance treatment with an ORR of 10% and stable disease in 50% of p. The median overall survival (OS) for all patients was 12.6 months (95% CI 10.8 – 14.3). There were statistically significant differences in OS according histological subtype. The median OS for epithelioid was significantly longer (15 months, 95% CI 13.8-18) as compared with non-epithelioid (7 months 95% CI 4.3-9, p<0.001). There were no statistically significant differences in OS according to gender, asbestos exposure or type of platinum chemotherapy (Cisplatin 15.2 months 95% CI: 13.7-18.75; vs. Carboplatin 18 months 95% 12-25.3, p=0.32).
Conclusion:
In Spain, OS of MPM patients treated with platinum palliative chemotherapy exceeded the median OS reported in phase III trials.
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P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.03-033 - <sup>18</sup>FDG-PET/CT Improves Lung Cancer Staging and Treatment Selection Accuracy (ID 279)
09:30 - 17:00 | Author(s): M. Majem
- Abstract
Background:
Integrated [18]F-fluorodeoxyglucose Positron-Emission Tomography - Computed tomography ([18]FDG-PET/CT) has emerged as the new standard in staging and treatment planning for patients with lung cancer, not only improving the diagnostic accuracy of mediastinal nodal involvement but also the detection of metastases. The aim of this study is to analyse this data in our centre and to evaluate the treatment variations derived from the results of this technique.
Methods:
We included patients with proven or suspected lung cancer diagnosed between September 2010 and February 2014. A computed tomography (CT) and [18]FDG-PET/CT were performed in all patients, both explorations were evaluated separately, and a tumour-node-metastasis (TNM) stage and a specific treatment based on its results was established for each technique. We used the 7[th] TNM edition, and nodal stations were identified according to mapping system of the American Thoracic Society.
Results:
We included 249 patients, the median age was 65 years (23-88), the 78.7% were males and the 21.2% were females. Non-small cell lung cancer (NSCLC) represented an 86.3% and small-cell-lung cancer (SCLC) a 8%. In 14 patients (5.6%) no pathologic diagnosis was established. In 137 of 249 (55%) patients no change in staging between CT and [18]FDG-PET/CT was observed: 65 (47.4%) were stage I, 10 (7.2%) stage II, 22 (16%) stage IIIA, 22 (16%) stage IIIB and 18 (7.2%) stage IV. Compared with CT,[ 18]FDG-PET/CT provided additional information in 112 of 249 patients (45 %): 36 patients (14,4%) had downstaging, and a curative treatment was feasible in 13 patients (5.2%) (1 SCLC, 12 NSCLC). Seventy six patients (30.5%) had upstaging, and a palliative treatment was proposed to 49 of them (19.67%) (10 SCLC, 37 NSCLC, 2 without histology). **Of-line: occult metastases were detected in 49 of 249 patients, which represent a 19.67%.
Conclusion:
The study confirms that in our institution, integrated [18]FDG-PET/CT improves both lung cancer staging in all histologies and the treatment selection accuracy.
