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M. Nakanishi



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    P1.15 - Poster Session 1 - Thymoma (ID 189)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Thymoma & Other Thoracic Malignancies
    • Presentations: 1
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      P1.15-003 - Phase II study of amrubicin (AMR) and carboplatin (CBDCA) for invasive thymoma (IT) and thymic carcinoma (TC) : North Japan Lung Cancer Group 0803 (ID 951)

      09:30 - 16:30  |  Author(s): M. Nakanishi

      • Abstract

      Background
      There has been no standard chemotherapy for advanced thymic malignancies including invasive thymoma(IT) and thymic carcinoma(TC) although anthracycline or platinum agents have been commonly used for them. AMR, a new anthracycline agent, was approved for lung cancer in Japan and we had previously conducted some prospective studies of AMR combined with CBDCA for patients with small-cell lung cancer, which revealed this regimen was active with acceptable toxicity. The objective of this study is to evaluate the efficacy and safety of this combination for patients with advanced thymic malignancies.

      Methods
      Patients with histologically confirmed thymic malignancies received AMR (35 mg/m2, day1-3) and CBDCA (AUC 4.0, day1) every 3 weeks. Patients who underwent previous chemotherapy received reduced dose of AMR (30 mg/m2). The primary endpoint was overall response rate (ORR), and secondary endpoints were progression-free survival (PFS), overall survival and toxicity profile. Assuming that ORR of 75% and 45% would indicate the potential usefulness while ORR of 50% and 20% would be the lower limit of interest, with alpha = 0.10 and beta = 0.20, for IT patients and TC patients, respectively, 18 IT patients and 16 TC patients were at least required.

      Results
      From December 2008 to October 2012, 51 patients (18 IT and 33 TC) were enrolled from 20 institutions in Japan. The ORR and disease control rate were 17% and 89% in IT, and 30% and 85% in TC. Median PFS was 7.6 months in both groups. Toxicity was generally moderate and no treatment related death was observed.

      Conclusion
      This is the largest prospective study of chemotherapy for advanced thymic malignancies. AMR combined with CBDCA was effective for TC patients with acceptable toxicities.

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    P2.22 - Poster Session 2 - Epidemiology, Etiology (ID 167)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      P2.22-005 - Clinicopathologic Characteristics of Lung Cancer Associated with Pleural Plaques (ID 1555)

      09:30 - 16:30  |  Author(s): M. Nakanishi

      • Abstract

      Background
      In Japan, crocidolite had been used for asbestos cement pipe and spraying and amosite had been used for building board and spraying. These two types of asbestos had stopped to use in Japan in the late 1970s. Asbestos exposure will increase the risk of lung cancer, mesothelioma and nonmalignant lung parenchymal and pleural disorders, including asbestosis, pleural plaques, pleural thickening, and pleural effusions. Asbestosis is a form of diffuse interstitial pulmonary fibrosis and pneumoconiosis caused by the inhalation of excessive amounts of asbestos fibers. By contrast, pleural plaques are the most frequent response to asbestos exposure, appearing even with low-dose, often intermittent, exposures. Plaques occupy irregular, discrete areas on the parietal pleura and are often found as incidental chest radiographic findings. Therefore, radiographic evidence of pleural plaques in lung cancer patients indicates the history of asbestos exposure.

      Methods
      Between 2003 and 2011 in our hospital, there were 979 patients in whom pleural plaque was confirmed by computed tomography (CT) scanning of the chest. Among those patients, 62 were histologically diagnosed as primary lung cancer.

      Results
      Grouped according to sex, there were 61 men and an woman. The frequent histologic types of the cancers were adenocarcinoma ( 21 patients ) and squamous cell carcinoma ( 22 patients ), followed by small cell carcinoma (8 paients). 16 patients had Stage1A disease, 8 patients had stage 1B disease, 3 patients had stage 2B disease, 8 patients had stage 3A disease, 6 patients had stage 3B disease and 21 patients had stage 4 disease. The median overall survival was 23.0 months and 1 year, 2 year and 5 year survival rate of all the patients were 56.0 %, 49.0 % and 23.7 %, respectively. Based on the primary treatment, 28 patients received surgery, 4 patients received radiation therapy, 5 patients received chemoradiotherapy, 19 patients received chemotherapy and 6 patients received best supportive care. The median overall survival of the patients treated by surgery, radiation therapy, chemoradiotherapy, chemotherapy, and best supportive care, were 96.0 months, 40.9 months, 6.3 months, 8.4 months and 3.0 months, respectively. Six patients showed radiographic findings of asbestosis accompanied with pleural plaques. Five patients received surgery and a patients received chemotherapy as a primary treatment, but the median overall survival of these 6 patients was as short as 6.5 months.

      Conclusion
      Among the lung cancer patients associated with pleural plaques alone, early stage patients showed favorable prognosis. But the lung cancer patients in whom pleural plaque and asbestosis were detectable in chest CT showed poor prognosis even after diagnosis at early stage. Therefore, the early detection of lung cancer may contribute to a better outcome in the population which has pleural plaque alone, not accompanied with asbestosis.