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M. Misic



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    P1.02 - Poster Session with Presenters Present (ID 454)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Biology/Pathology
    • Presentations: 1
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      P1.02-049 - EGFR, KRAS and ALK Gene Alterations in Lung Cancer Patients in Croatia (ID 5943)

      14:30 - 15:45  |  Author(s): M. Misic

      • Abstract

      Background:
      Rates in targetable gene changes varies between different populations of lung cancer patients. Targetable gene changes include changes in EGFR and ALK gene, as well as KRAS gene. Primary aim of this study was to determine mutation status in purely Caucasian Croatian population.

      Methods:
      Rates in targetable gene changes varies between different populations of lung cancer patients. Targetable gene changes include changes in EGFR and ALK gene, as well as KRAS gene. Primary aim of this study was to determine mutation status in purely Caucasian Croatian population.

      Results:
      During 6 months period 324 newely diagnosed primary lung adenocarcinoma were tested. Out of 324 tested patients, 194 were males (60%) and 130 females (40%) mean age 64 years (range 35 to 88 years). Vast majority of patients were in stages 3 and 4 (more than 80%). Among males, 87% of patients were ever smokers, and among females 61% of patients were ever smokers. Significantly higher rates of evers smokers were recorded among males. EGFR mutations were present in 15.7% of patients (51 patients). There was a difference in EGFR mutation rates between males and females (5.6 vs 30.8%, p<0.0001). KRAS mutations (codones 12/12 and 61) were present in 35.8% (116) patients, and ALK translocation detected by IHC in 3.7% (12) patients.

      Conclusion:
      Molecular testing in primary lung adenocarcinoma patients was done in purely Caucasian Croatian population. EGFR mutation and ALK translocation rates were similar to previously published data. However, KRAS mutation rates were higher than previously published. This can be associated with high smoking rates in Croatian population.

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    P3.02b - Poster Session with Presenters Present (ID 494)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P3.02b-114 - Second Line Treatment of EGFR Positive Lung Adenocarcinoma - Our Experience (ID 6064)

      14:30 - 15:45  |  Author(s): M. Misic

      • Abstract

      Background:
      EGFR testing and specific targeted therapy of lung adenocarcinoma is a standard worldwide. In Croatia, tirosin-kinase inhibitors (TKI)are allowed as a second-line therapy for EGFR positive (+) patients. We analysed the median overall survival (mOS) differences between TKI- and.conventional chemotherapy-treated patients as a second-line therapy.

      Methods:
      Medical records of patients diagnosed with lung adenocarcinoma and tested for specific mutations in Clinical hospital center Zagreb, Department for respiratory diseases Jordanovac, during the year 2013 and 2014, were retrospectively collected and reviewed. Median overall survival (mOS) was measured and analyzed using routine statistic tests.

      Results:
      A total of 334 patients were tested for EGFR mutations, 47 of whom came positive and 287 negative. There was signifficant difference between the two subgroups regarding some demographic categories: the majority (78,7%) of the EGFR + patients were female, as opposed to the EGFR - group. Also, the EGFR+ patients were older on average ath time of diagnosis.(66,04 vs 63,04 years). After recieving first line platinum based chemotherapy a total of 20 positive EGFR patients recieved second-line therapy. 15 were treated with TKI and 5 recieved pemetrexed. In the EGFR negative group, 100 patients received second-line therapy, 85 of whom recieved pemetrexed and the other 15 were treated with platinum- or gemcitabine- based chemotherapy. If analysing mOS of all the patients, there was statistically significant difference between the TKI-treated patients (mOS not met) compared to the other ones (mOS=20 months) (chi-square= 6,07; p=0,014). Also, if analysing only the EGFR positive patients, the mOS difference reached statistical significance, comparing the TKI-treated patients (mOS =24,3months) with those treated with pemetrexed. (mOS=15,7 months) (chi-square= 7,99; p=0,005)

      Conclusion:
      Our results showed the significance of molecular testing and specific TKI treatment of patients with EGFR positive lung adenocarcinoma, as they had a significatly better overall survival compared to patients treated with pemetrexed. The results are conclusive with the general experience and treatment recommendations, and should be implemented in every day praxis, i.e. enabling molecular testing and specific treatment for all EGFR+ patients, at least as a second-line therapy option, should be an imperative.