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B. Laderian
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P1.01 - Poster Session with Presenters Present (ID 453)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Epidemiology/Tobacco Control and Cessation/Prevention
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.01-043 - Comparison of Gender, Race Distribution, and Survival in the 1990s to 2010s in Lung Cancer Patients at a Single Institution (ID 4678)
14:30 - 15:45 | Author(s): B. Laderian
- Abstract
Background:
In the United States, lung cancer occurs in about 225,000 patients and causes over 158,000 deaths annually. Due to a shift in smoking patterns between the genders that started decades ago, the incidence of lung cancers appeared to have shifted accordingly. Thus, we analyzed our institutional data as described below.
Methods:
This is a retrospective study that compares two populations of lung cancer patients in two different five-year periods a decade apart: one from 1996 to 2000 consisting of 1355 lung cancer patients and the other from 2011 to 2015 consisting of 2220 lung cancer patients from our institutional tumor registry data. We included lung cancers that have been associated with smoking such as adenocarcinoma, squamous cell carcinoma, and small cell lung cancer. The two populations were compared in category of gender; race and marital status were also included to examine any major population shifts during these time periods. Crude survival at two-year follow up period was also examined. The results were analyzed using Excel as well as Matlab. This project is IRB approved.
Results:
From 1996 to 2000, the percentage of male population with lung cancer associated with smoking was 63%. This number decreased significantly to 51% in the period 2011-2015 (p-value < 0.00001). The percentage of African American patients in 1996-2000 was 14% and decreased to 11% in 2011-2015 (p-value 0.0039). The number of divorced patients increased from 8.1% to 11% (p-value 0.0025). The number of widowed patients decreased from 12.3% to 9.8% (p-value 0.0096). For patients with stage IV lung cancer diagnosed from 1996 to 1998, the crude survival rate at 2-year follow up was 17%, which increased to 29% in patients diagnosed from 2011 to 2013 (p-value < 0.00001).
Conclusion:
Our results demonstrate that the proportionate incidence of lung cancer in males has decreased significantly from the late 90s to the early 2010s. The change in race and marital status, while statistically significant, is less dramatic. The percentage of African American population has also decreased significantly. The crude survival rate at 2 year follow up for those with stage IV lung cancer significantly increased. While this could, in part, be due to stage migration, a real prolongation due to improvements in systemic therapy is likely. More attention should be drawn to the fact that nearly twice as many women die from lung cancer compared to breast cancer, for a more proportionate support of research efforts.
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P3.02c - Poster Session with Presenters Present (ID 472)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02c-081 - Complete Blood Count Parameters as Predictive Factors in Patients with Advanced Non-Small Cell Lung Cancer Treated with Nivolumab (ID 6150)
14:30 - 15:45 | Author(s): B. Laderian
- Abstract
Background:
Checkpoint inhibitors such as nivolumab (anti-PD1) represent a recent breakthrough in the management of patients with advanced non-small cell lung cancer (NSCLC) after disease progression following initial platinum-based therapy. Prospective identification of likely responders remains a challenge as PDL-1 testing, while helpful, is imperfect. Identifying additional indicators is warranted. Studies in melanoma patients demonstrated that analyzing some baseline clinical laboratory parameters had predictive value in the setting of immunotherapy (Weide et al Clin Can Res 2016, and Ferrucci et al BJC 2015). We attempted the same in our lung cancer population.
Methods:
We performed a retrospective analysis in a patient population with biopsy proven advanced NSCLC who received nivolumab. Patient charts were reviewed to obtain data on demographics, ECOG performance status, stage, number of previous therapies, and baseline complete blood count (CBC), from which the ratio of absolute neutrophil count (ANC) to absolute lymphocyte count (ALC) was calculated. Imaging data for response assessment were available. Univariate analysis was performed to study the association between clinical and demographic parameters and progression-free survival (PFS) using SAS software.
Results:
In our cohort of 114 patients treated during 2015-2016, the median follow-up was 5.4 months (range 0-15.8), median age was 67 years (range 40-91), and median number of prior therapies was 2. There were 52% males, 60% Caucasians, 32% Hispanics, 8% African Americans, and 75% had ECOG performance status of 0-1. Our univariate analysis showed the following: Figure 1
Conclusion:
Our data indicates that low baseline ANC/ALC (<5), female gender, and ECOG 0-1 are independent factors associated with significantly favorable PFS in patients with advanced NSCLC treated with nivolumab. A more detailed analysis of a larger cohort, including data on mutational burden, will be presented.
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P3.05 - Poster Session with Presenters Present (ID 475)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Palliative Care/Ethics
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.05-009 - Medical Marijuana and Lung Cancer: Patients' Knowledge and Attitude towards Its Use (ID 3994)
14:30 - 15:45 | Author(s): B. Laderian
- Abstract
Background:
Management of cancer-related symptoms in patients with lung cancer can be challengeing. Increasing number of patients have turned to cannabis plant to alleviate those symptoms. Some studies have shown potential benefits, however it is still classified as an illegal schedule I drug in the US. There is a shortage of research on its use in cancer patients. Additionally, there is fear, bias and stigma associated with its use. In this study, we set out to investigate patients' knowledge and views on the use of marijuana.
Methods:
Patients with advanced lung cancer over 18 years of age were included. They had to be receiving systemic intravenous treatment (chemotherapy, immunotherapy, biologic therapy), able to give informed consent and fluent in English. Study was explained by a trained research staff, written informed consent was obtained, and patients were given the survey to fill without assistance. Study was IRB approved.
Results:
A total of 20 patients were enrolled. They were 70% females, 30% males, 15% Hispanic, 5% Asian, 70% white, and 30% black. The majority of patients were symptomatic with 50% having pain, 25% nausea, 30% weight loss, 45% poor appetite and 65% with other symptoms most commonly fatigue. The majority (85%) have heard of the use of medical marijuana for cancer, 40% thought it helped treat the cancer, 75% thought it reduced side effects of treatment, 70% helped with pain, 60% helped with weight gain, and 70% helped with psychological distress. In this group, 82% have considered using marijuana, 70% thought they are able to obtain it. Only 15% said they would smoke it, while 30% would use a vaporized form, and 75% would use it in an edible form. Forty one percent of the patients expressed concerns regarding the legal risk of purchasing marijuana in Florida, while only 23% expressed concerns regarding the legal risk of using it. One hundred percent of the patients felt it should be legally available to cancer patients, and 100% expressed the need for a trusted educational resource for learning about Marijuana use. Overall, 94% of the patients would consider using it if legalized.
Conclusion:
To our knowledge, this is the first study focusing on lung cancer patients and their awareness regarding a highly controversial and currently illegal substance. Patients are interested in a robust educational resource regarding its benefit or lack thereof. More research focusing on this modality for palliation of symptoms in lung cancer patients is urgently needed.
