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M. Kozlowski



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    P1.03 - Poster Session with Presenters Present (ID 455)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Radiology/Staging/Screening
    • Presentations: 1
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      P1.03-002 - Can We Discriminate between Different Subtypes of Non-Small Cell Cancer Patients Based on Plasma Metabolic Fingerprint? (ID 4598)

      14:30 - 15:45  |  Author(s): M. Kozlowski

      • Abstract

      Background:
      Progress in understanding the pathogenesis of non-small cell lung cancer (NSCLC) led to the development of molecularly targeted agents, including those targeting selected growth factors: vascular endothelial (VEGF), platelet-derived (PDGF), epidermal (EGF), insulin-like I (IGF-I), and anaplastic lymphoma kinase (ALK) signaling. Interestingly, clinical trials of targeted agents and newer chemotherapy agents yielded differences in outcomes according to histologic subgroups providing a rationale for histology-based treatment approaches. Consequently, a correct histologic diagnosis is becoming increasingly important. However, even the most careful examination of biopsies by expert pulmonary pathologists leave about 10-30% of NSCLC as not specified. Metabolomics is widely used for biomarkers discovery and patients stratification. This novel tool may provide additional diagnostic markers, which could support proper NSCLC subtyping. In the present study plasma samples obtained from patients with the major NSCLC histologic subtypes and controls were fingerprinted by liquid chromatography - mass spectrometry (LC-MS) method.

      Methods:
      The study was performed on the group of 63 NSCLC patients and 32 controls. Based on the histology evidence the patients were classified as ADC (n=20), LCC (n=13), and SCC (n=30). Individuals in all studied groups were matched in age (62±10 years), sex (15-38%F) and BMI (26±3). Metabolites extracted from plasma were analyzed by use of LC-QTOF-MS in positive and negative ion modes. Metabolic features repetitively measured in QC samples (RSD<20%) and present in at least 90% of the samples were forwarded to statistical analysis. Depending on data distribution t-test or U-test were used to select metabolites significantly different between controls and NSCLC patients. ANOVA was used to select metabolites discriminating between NSCLC subtypes. Multivariate analysis was used to show subtype-related patients’ classification.

      Results:
      Identification of plasma metabolites significantly different between controls and NSCLC showed differences in phospholipids (e.g. PC 34:3, +53% in NSCLC, p=0.01; PC 36:4, +50% in NSCLC, p=0.001; Lyso PC 18:3, +37% in NSCLC, p=0.02; PE 34:2, +36% in NSCLC, p=0.0002) and docosahexaenoic fatty acid (-34% in NSCLC, p=0.02). Based on metabolites significant after ANOVA analysis it was possible to build good quality (R[2]=0.652, Q[2]=0.408) partial least square discriminant analysis (PLS-DA) model separating NSCLC subtypes. Among metabolites responsible for this separation sphinganine (p=0.009), anandamide (p=0.009), malonyl carnitine (p=0.001), and Lyso PE 20:5 (p=0.02) can be mentioned.

      Conclusion:
      Metabolic fingerprinting of plasma samples allowed for selection a panel of metabolites able to discriminate between NSCLC subtypes. Although promising, obtained results require further validation with target methods and on larger cohort of patients. Acknowledgements: The study was funded by National Science Centre, Poland (2014/13/B/NZ5/01256).

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    P2.02 - Poster Session with Presenters Present (ID 462)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Locally Advanced NSCLC
    • Presentations: 1
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      P2.02-011 - Management of Non-Small-Cell Lung Cancer (NSCLC) Stage III Patients in Central European Countries (ID 4608)

      14:30 - 15:45  |  Author(s): M. Kozlowski

      • Abstract

      Background:
      The aim of the study is to determine the actual standard management of patients with stage III NSCLC in Central European centres/countries. The project is a multicentre, prospective, non-interventional registry.

      Methods:
      After ethical committee approval and signed informed consent, the data about diagnostic and therapeutic procedures of consecutive patients diagnosed with stage III NSCLC (UICC7) were collected in web-based registry organised by the IBA MUNI, Brno, Czech Republic.

      Results:
      With cut-off 30 June 2016, 509 patients from 7 countries/16 centres were enrolled, median number of patients per centre being 23 (range 6-99). There were 163 (32%) women and 37 (7%) never smokers. Performance status distribution was as follows: ECOG 0, 1, 2 and 3 in 29%, 56%, 12% and 3%, respectively. Squamous cancer was found in 52%, adenocarcinoma in 39%, not otherwise specified in 5% and others in 4% of cases. Genetic mutations were examined in 119 (23%) patients, predominantly EGFR in 111 subjects with 10 (8%) positive findings, while the ALK mutation in 64 patients with no positive finding. Regular staging procedures were X-Ray scan (97%), chest CT (96%) and bronchoscopy (89%). Staging was completed by abdominal CT in 66% of patients, abdominal US in 29%, PET/CT in 22%, bone scan in 17% and brain CT or MRI in 13%, respectively. Stage IIIA was found in 59% and stage IIIB in 41% of patients. N2/N3 nodes were diagnosed in 60%/22% of patients. Pathological mediastinal lymph-node positivity was confirmed in 109 (21%) patients (6% EBUS, 0.2% VATS, 1% mediastinoscopy, 1% transbronchial biopsy and 13% surgery). Median time from diagnosis to first treatment was 23 days (range 0–321). Treatment procedures were: surgery 138 (27%), chest radiotherapy 246 (48%) and chemotherapy 409 (80%) of subjects, respectively. Chemotherapy as only modality was given in 136 (27%) of patients. Surgery was combined with radiation in 6 cases, with chemotherapy in 79 (16%) cases and with both chemotherapy and radiotherapy in 37 (7%) patients. Chemotherapy plus radiotherapy was given in 159 (31%) patients including concurrent chemoradiotherapy in 67 (13%) cases. At the time of cut-off, 64% patients were alive, median survival time was not reached, and the 1-year estimated survival rate was 71%.

      Conclusion:
      The most prevalent histology was squamous cancer. Histopathological examination of mediastinal lymph-nodes was done in 21% of patients, mostly during surgery. Majority of patients (55%) were treated with combination therapy. Palliative chemotherapy only was given in 27% of patients. Survival data are not mature.