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J. Puente Vázquez



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    P1.06 - Poster Session 1 - Prognostic and Predictive Biomarkers (ID 161)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Biology
    • Presentations: 1
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      P1.06-006 - Prognostic value of serial peripheral circulating tumour cells (CTC) evaluation in patients with advanced non-small cell lung cancer (NSCLC) during first line treatment. (ID 841)

      09:30 - 16:30  |  Author(s): J. Puente Vázquez

      • Abstract

      Background
      Treatment strategy in lung cancer is lack of surrogate markers that may improve the clinical management in such an aggressive and deadliest tumour. Recently, CTC detection and characterization has been suggested as a promising and valuable outcome biomarker that is beginning to be elucidated in this context. The study investigates whether CTC reduction along treatment has a prognostic significance in previously untreated patients with advanced NSCLC receiving chemotherapy.

      Methods
      Patients with histologically confirmed stage III or IV NSCLC and suitable for chemotherapy treatment were selected for the study irrespective of other baseline characteristics. From each patient, two peripheral blood samples for CTC analysis were collected at baseline and concomitantly with first radiological evaluation, after three cycles of chemotherapy. CTC expressing EpCAM were detected in the semiautomated platform; the CellSearch® system.

      Results
      In this single institution prospective study, 25 consecutive patients were included between April 2011 and January 2013. The patients had a median age of 67 years (range 41-80), most were former or current smokers (60% and 32%, respectively), had ECOG 1 (80%), adenocarcinoma subtype (80%) and stage IV tumour at diagnosis (84%). First line platinum-containing chemotherapy was combined with antiangiogenics in 64% and with antifolates in 36% of patients. After 34 months of follow up, the median overall survival for the whole population was 10.9 months (95% IC 6.9-15 months). A non-significant survival benefit was identified in the group of patients for whom a reduction in CTC enumeration was achieved (N=12), in comparison to those with equal or greater number of CTC detected (N=13) between the first and second blood samples collected [11.2 months (95%IC 9.07 – 13.4) vs 7.2 months (95% IC 4.9 – 9.5); p=0.44] (figure 1). However, progression free survival was similar in both groups of patients (5.9 months vs 5.6 months, respectively). Figure 1 Figure 1. Kaplan-Meier curves for overall survival (OS) of patients with a reduction in the number of CTC (R-CTC) versus patients with equal or greater number of CTC (NR-CTC) detected in peripheral blood samples during chemotherapy treatment.

      Conclusion
      CTC serial isolation along treatment is a non-invasive tool that shows an encouraging prognostic value in advanced non-small cell lung cancer. Those findings strengthen the introduction of outcome markers in treatment decisions in this setting, but warrants further investigation for its validation in larger studies.

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    P1.11 - Poster Session 1 - NSCLC Novel Therapies (ID 208)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.11-005 - EVEREST Study: Evolution of disease-related symptoms of patients (p) with advanced non-small cell lung cancer (NSCLC) and its correlation with response to first-line (1L) treatment. (ID 3277)

      09:30 - 16:30  |  Author(s): J. Puente Vázquez

      • Abstract

      Background
      The control of symptoms to maintain the health-related quality of life continues to be a priority in the treatment of advanced NSCLC. The aim of our study was to assess the evolution of the disease-related symptoms and, due to the lack of evidence, to evaluate its correlation with the response to 1L treatment in p with advanced NSCLC.

      Methods
      EVEREST is an observational prospective study carried out in 33 Spanish institutions. A total of 155 p with advanced NSCLC initiating standard platinum-based 1L treatment were included. Disease-related symptoms were assessed at baseline and after completing 4-6 cycles of 1L treatment (final visit) with the Lung Cancer Symptom Scale (LCSS) and an ad-hoc specific questionnaire evaluating their frequency. Response to treatment was assessed according to RECIST criteria.

      Results
      Baseline characteristics of the 155 p enrolled were: 76.1% male, 96.1% Caucasian, 70.3% adenocarcinoma, 16.8% squamous-cell carcinoma; median age was 62 years. ECOG PS 0/1/2: 26.5%/54.8%/14.8%. 65.3% and 12.9% of p maintained or improved the ECOG status during the study, respectively. 118 p completed at least 4 cycles of treatment. Best response to 1L treatment was: 1.7% complete response, 68.4% partial response and 26.5% stable disease. Most frequent disease-related symptoms were asthenia and pain. 1L treatment did not deteriorate disease-related symptoms compared to baseline (LCSS score was reduced 1.4 points) and an improvement in cough was observed (p=0.026). The frequency of cough (p<0.001), dyspnea (p=0.025), pain (p=0.009) and discomfort (p=0.034) were significantly reduced. No significant correlation with response to treatment and the evolution of symptomology between visits was found.

      Conclusion
      1L treatment was associated with a reduction of the frequency (cough, dyspnea, pain and discomfort) and intensity (cough) of disease-related symptoms in p with advanced NSCLC, irrespective of the response achieved.