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T. Kashii
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G02 - Global Lung Cancer Coalition (GLCC) Session: Deserve Better - Expect Better: Advocating for Better Outcomes for Lung Cancer Patients (ID 15)
- Event: WCLC 2013
- Type: Other Sessions
- Track: Nurses
- Presentations: 1
- Moderators:P. Goldstraw, M. Peters
- Coordinates: 10/28/2013, 16:15 - 17:45, Bayside 105, Level 1
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G02.3 - Clinicians as Advocates: Raising Public Awareness of Lung Cancer - The West Japan Oncology Group Experience (ID 441)
16:15 - 17:45 | Author(s): T. Kashii
- Abstract
- Presentation
Abstract
Background: In Japan and Asian countries, patient advocacy has not been popular to citizens and government, especially in patients with lung cancer compared to USA and EU countries. Therefore, a few clinicians had played a role as advocate instead of cancer survivors group or governments. Clinicians as advocates have a certain advantage to give professional information by themselves, with trained communication skill about bad news, and to use medical resources which is involved to medical society for lung cancer or hospital. West Japan Oncology Group (WJOG), non-profit organization which was established in 2000 by volunteer oncologists, has the mission to conduct and support multi-center clinical co-operative study for cancer and to provide the information about lung cancer, the importance and necessity of clinical study for standard treatment widely, therefore to contribute improving social welfare. Methods: To achieve the mission of WJOG, we carried out open lecture in city hall in major city every year and published lecture recordings in newspaper as well DVD video distribution. In another way, we planed to publish the guideline book for the patients with lung cancer and revised in five years interval. The board of directors determined the plan and the guideline editors committee was organized by WJOG member in March, 2006. The committee edited constitution, drafting, plan, writing as an enterprise in 2006, and 2011. Questions and answers style was adopted in accordance to previous US guidebook . Results: In these 12 years, 27 times of open lecture were held and medical specialists for oncology, novelists with cancer, representative or president of organization for patients advocacy, and etc gave lecture and discussed with patients. Nearly two to eight hundred people had participated in each meeting, occupied by most women and senior citizens. The questionnaire survey to participant revealed satisfaction for lecture and expectation for next meeting. The contents of lecture appeared full page in the Asahi which has a large circulation of almost 8 million (the second position in the world) as well as DVD-video was distributed widely to institute participating to our study and patients for the purpose of providing larger citizens with useful information. Furthermore WJOG official web site show the detail of each lecture in Japanese because Japanese patients with lung cancer are old and difficult to read English web site. Last year, second edition guideline book for patients was edited which consists of 118 questions and answers with full color 200 pages, as well posted to the WJOG website. GLCC international quantitative survey in 2010 showed that Japan is one of the countries with the greatest proportion of adults who think lung cancer is the biggest killer Conclusions: It seems that patient advocacy is developed to be more popular through open lecture, newspaper, web site and guideline book even in Japan. This method may be one of the ways to raise public awareness of lung cancer in Asian countries.Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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P2.10 - Poster Session 2 - Chemotherapy (ID 207)
- Event: WCLC 2013
- Type: Poster Session
- Track: Medical Oncology
- Presentations: 2
- Moderators:
- Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level
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P2.10-024 - Usefulness of creatinine/cystatin C ratio as a predictive marker for adverse effects of chemotherapy. (ID 1513)
09:30 - 16:30 | Author(s): T. Kashii
- Abstract
Background
Cystatin C has often been used as a marker of renal function and rarely is influenced by muscle mass, whereas the Creatinine/cystatine C ratio (Cr/CysC) is influenced by muscle mass. However, it is unknown if the Cr/CysC ratio can be used as a predicitive marker for adverse side effects of chemotherapy. The aim of this study is to if the Cr/CysC ratio can be used as a predictive marker for adverse effects of chemotherapy.Methods
We measured cystatin C levels in 25 patients with either non-small cell cancer (NSCLC) or small cell lung cancer (SCLC) as a marker of renal function at the initial commencement of chemotherapy and conducted a retrospective comparative study utilizing the Cr/CysC ratio and clinical data.Results
Patient characteristics were as follows: median age = 67 years (age range 54-84 years; age 70 ≤ 10 out of 15 cases); male:female = 23:3; NSCLC:SCLC = 18:7; ECOG PS 0-1:2 = 22:3. Epidermal growth factor receptor (EGFR) genetic mutation was observed in one case, was not present in 13 cases, and the remaining 11 cases were unknown. Twenty two cases were in the first line therapy, and 3 cases were in the second line therapy. The ratio of platinum-based combination to single agent therapy was 20:5 cases. NSCLC patients with toxicity grades over 3 had hematological toxicity (n = 4, 22.2%) and non-hematological toxicity (n = 3, 16.7%). All SCLC patients with toxicity grades over 3 had hematological toxicity (n = 7, 100%) while non-hematological toxicity wasn’t present (n = 0, 0%). There were no significant differences between the Cr/CysC ratios in patients > 70 years. There was a highly significant difference in the Cr/CysC ratios in patients with NSCLC and patients with SCLC (0.92 vs 0.78, p < 0.05). There was significant difference between Cr/CysC ratios in patients with toxicity grade over 3 and under 2 (0.84 vs 0.70, p＜0.05), and this trend was also shown in the confined platinum-based combination therapy group (0.85 vs 0.69, p < 0.05).Conclusion
The Cr/CysC ratio could prove useful as a predictive marker for adverse effects of chemotherapy in patients with NSCLC. -
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P2.10-027 - Mutation of epidermal growth factor receptor gene and efficacy of gefitinib in squamous cell carcinoma of lung (ID 1582)
09:30 - 16:30 | Author(s): T. Kashii
- Abstract
Background
The epidermal growth factor receptor (EGFR) gene mutation has been reported as an important predictive factor for EGFR-tyrosine kinase inhibitor (TKI) efficacy in NSCLC. In "The Lung Cancer Diagnosis and Treatment Guideline published by The Japan Lung Cancer Society 2012 edition", the EGFR gene mutation is strongly recommended to be analyzed in deciding the treatment policy of advanced non- squamous cell carcinoma. In addition, it is known that the EGFR gene mutation is frequently observed in adenocarcinoma (Ad), but very rare in squamous cell carcinoma (Sq). Efficacy of EGFR-TKI in EGFR gene mutation positive Sq has not examined enough.Methods
We obtained tumor samples from 50 patients diagnosed as Sq (excluded Ad-Sq carcinoma) by two or more pathologist between January 2008 to March 2013. The EGFR gene mutation status was determined by PCR-Invader assay (BML Incorporation) and direct sequencing method.Results
EGFR gene mutations were detected in 2 of 50 (4%) samples. Common characteristics of two patients were male, elderly, high level of CEA, and good PS. One patient was an on-smoker and the other was a heavy smoker. The type of the EGFR gene mutation was both exon 21 point mutation. Gefitinib was administered to two patients and PRs were observed. Their progression-free-suvival were 9 months and 20 months.Conclusion
The frequency of the EGFR gene mutation in Sq was low. However, it was suggested that gene mutation positive Sq is responded to EGFR-TKI. It is necessary to analyze the EGFR gene mutation in Sq.
