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B. Zaric



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    MINI 28 - Psychological Impact of Lung Cancer and its Treatment (ID 150)

    • Event: WCLC 2015
    • Type: Mini Oral
    • Track: Palliative and Supportive Care
    • Presentations: 1
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      MINI28.05 - Depression and Anxiety in Lung Cancer Patients: The Unmet Need for Recognition and Early Detection (ID 2407)

      16:45 - 18:15  |  Author(s): B. Zaric

      • Abstract
      • Presentation
      • Slides

      Background:
      Anxiety and depression are present in significant number of patients with lung cancer. Aims of this trial were to examine the frequency of depression and anxiety in lung cancer (LC) patients and to investigate relations between clinico-pathological characteristics (CPC) and depression and anxiety disorders.

      Methods:
      This prospective observational trial was conducted at Institute for Pulmonary Diseases of Vojvodina, Serbia. Two hundred and eight LC patients at various stages of disease and treatment rated themselves on the Hospital Anxiety and Depression Scale (HADS). Investigated CPC among other were Eastern Cooperative Oncology Group Performance Status (ECOG PS), tumor type and tobacco abuse. In order to correlate the data univariate and multivariate analysis was performed.

      Results:
      Of total 208 enrolled patients 76% (158) were males and 24% (50) females. Majority of patients were with ECOG PS 1 75% (156), smokers (58.7%), in stage III and IV (42.3% each) LC. Most frequent LC type was adenocarcinoma 46.6% (97) while squamous, small-cell and other types were confirmed in 38% (79), 13.5% (28) and 1.9% (4) respectively. Patients with brain metastasis and known depression and/or anxiety disorder before LC diagnosis were excluded from the trial. HADS-defined depression and/or anxiety were identified in 39.5% (82) patients. Frequency of anxiety was 22.6% (47) and of depression 36.1% (75). Both depression and anxiety severity were ranged from mild to severe. Combined depression with anxiety was identified in 19.2% (40) patients. We identified significant relation (p=0.003) between ECOG PS and anxiety. There is positive correlation between depression and ECOG PS (p=0.007). When depression and anxiety are present as combined disorders severity of each anxiety and depression are significantly higher (p<0.0001).

      MALE FEMALE
      N (%) 158(76%) 50(24%)
      ECOG PS 0 32(20.3%) 7(14%)
      1 115(72.8%) 41(82%)
      2 10(6.3%) 1(2%)
      3 1(0.6%) 1(2%)
      SMOKING Never 16(10.1%) 11(22%)
      Ex smoker 46(29.1%) 13(26%)
      Smoker 96(60.8%) 26(52%)
      PCKY Ex smoker 50,7 37,7
      (mean) Smoker 40,9 37,2
      TUMOR TYPE Adenocarcinoma 68(43%) 29(58%)
      Squamouse carcinoma 65(41.1%) 14(28%)
      Small-cell carcinoma 22(13.9%) 6(12%)
      Other 3(1.9%) 1(2%)
      STAGE I 14(8.9%) 2(4%)
      II 14(8.9) 2(4%)
      III 63(39.9%) 25(50%)
      IV 67(42.4%) 21(42%)
      DEPRESSION 59(37.3%) 16(32%)
      ANXIETY 37(23.4%) 10(20%)
      SEVERITY OF DEPRESSION Mild 34(21.5%) 8(16%)
      Moderate 20(12.7%) 8(16%)
      Severe 5(3.2%) -
      SEVERITY OF ANXIETY Mild 22(13.9%) 5(10%)
      Moderate 10(6.3%) 3(6%)
      Severe 5(3.2%) 2(4%)


      Conclusion:
      Anxiety and depression are diagnosed in significant number of lung cancer patients. Presence of these disorders can significantly influence quality of life of lung cancer patients. The results of this trial suggest that screening on depression and anxiety should be performed at any stage of disease course. Early recognition, detection and therapy can help in better control of depression and anxiety with aim to increase patients quality of life.

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    P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Biology, Pathology, and Molecular Testing
    • Presentations: 1
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      P3.04-017 - Acinar Subtype of Lung Adenocarcinoma Is Significantly Related to EML4-ALK Translocation in Eastern European Patients (ID 907)

      09:30 - 17:00  |  Author(s): B. Zaric

      • Abstract
      • Slides

      Background:
      The incidence of echinoderm microtubule-associated protein-like4-anaplastic lymphoma kinase (EML4-ALK) translocation among surgically treated patients with adenocarcinoma of the lung of the Eastern European ethnicity is underreported. The aim of this trial was the determination of EML4-ALK translocation frequency in investigated population, and the evaluation of correlations between lung adenocarcinoma subtype and clinical characteristics with mutation status.

      Methods:
      This was a prospective trial which included 195 patients with adenocarcinoma of the lung who underwent surgical treatment. ALK mutation screening was performed by immunohistochemistry (IHC). IHC scores of 2+ and 3+ were regarded as positive. Confirmatory FISH was performed in all IHC positive and in 2:1 ratio in negative patients.

      Results:
      Overall ALK mutation rate established by IHC was 6.2%, while FISH confirmed rate of 5.1%. The FISH confirmed ALK positivity in 7.6% Hungarians, 5.5% Serbians, and 6.6% Slovakians. Acinar subtype of adenocarcinoma of the lung was significantly (p=0.02) related to EML4-ALK positive mutation status. Most of the patients were males (56.9%), smokers (50.8%), or former smokers (28.7%) with acinar (55.4%) or solid (35.9%) adenocarcinoma of the lung. Sensitivity and specificity of IHC were 100% and 98.9% respectively.

      Conclusion:
      ALK mutation rate in surgically treated patients with adenocarcinoma of the lung was found to be 6.2% by IHC and 5.1% by FISH. Acinar subtype of the adenocarcinoma of the lung was significantly related to ALK positive mutation.

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