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C. Stathopoulos



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    P1.06 - Poster Session with Presenters Present (ID 458)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P1.06-029 - Epidemiologic, Clinical Characteristics and Therapeutic Strategy of Elderly NSCLC Patients Treated in a Single Institution (ID 5379)

      14:30 - 15:45  |  Author(s): C. Stathopoulos

      • Abstract
      • Slides

      Background:
      In NSCLC pts 40% are ≥ 70y with poor PS and increased comorbidities(cbs). The aim of this retrospective study is to present all data in 208 NSCLC pts stage IIIB and IV admitted in our unit between 1/2007- 3/2016.

      Methods:
      Group A(young old):51%,70-75years(y),Group B(old):49%,75-87y.Median PS:2(0-3). Histology: Adenocarcinoma(AC) 43%, Squamous carcinoma(SCC) 31%, Adenosquamous CC 10%, Large CC 5% and Large Neuroendocrine 11%. Metastasis: Liver 79%, Bones: 72%, Adrenal: 37%, Lung: 35%, Brain: 23% of pts. Cbs included: hypertension, diabetes,heart disease, dyslipidemia, COPD, hypothyroidism, osteoporosis, Parkinson and dementia in 81, 68, 56, 56, 52, 42, 14 and 6% of pts .In Group B had ≥3 comorbidities more often (59% vs 42%), p<0.05).

      Symptoms at presentation No of pts (%) N=208 Group A% N= 106 Group B N = 102 p
      Haemoptysis 163 (78%) 78(74%) 85(83%) 0.05
      Cough 69(33%) 35(33%) 34(33%) NS
      Dyspnoea 60(29%) 22(21%) 38(37%) x<0.01
      Chest discomfort 46(22%) 17(16%) 29(28%) 0.01
      Cervical lymphadenopathy 38(18%) 18(17%) 20(19%) NS
      SVCS 27(13%) 12(11%) 15(15%) NS
      Pancoast tumors 9(4%) 4(4%) 5(5%) NS


      Results:
      Four pts(4.5%) mutated received TKI ± chemo(CT) (Paclitaxel,Carboplatin,Bevacizumab) and are still in PR for 12+, 14+, 14+, 32+, 12+ mo respectively. In 40 selected pts (≥ 80y, PS=3, ± brain metastases ± ≥5 cbs ± weight loss ≥7%) single agent was given. RR in 44% with mPFS 7(3-12)mo, mOS 11(5-16)mo. The rest received 3 cycles least of chemo ± brain RT + GCSF support: ORR: 56% in A and 49% in B. mPFS: 9(3+ - 18)mo and mOS 18(3+ - 56+)mo, 17(3+ - 56+) in A and 16 (3+ - 44+) in B. RR was 64% and 34% for pts PS 0-1 vs 2-3, p<0.001. In 720 cycles (410 and 310 in A and B),toxicity grade ≥ III: Febrile neutropenia in 11 vs 19% cycles, p <0.01, Anemia in 23 vs 27%, p=NS, Thrombocytopenia in 25 vs 30%, p=NS, Mucositis in 11 vs 15%, p=NS.

      Conclusion:
      1. When indicative CT should be given, without reduction. 2. Haemoptysis and chest discomfort are common in older pts. 3. Febrile neutropenia was the main serious side effect. 4. GCSF prophylaxis is necessary. 5. In selective patients >80y single agent seems beneficial in second line .

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    P2.03a - Poster Session with Presenters Present (ID 464)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P2.03a-029 - Efficacy and Safety of Combined Carboplatin, Paclitaxel and Bevacizumab for Patients with Stage IIIb and IV Non-Squamous NSCLC (ID 5374)

      14:30 - 15:45  |  Author(s): C. Stathopoulos

      • Abstract
      • Slides

      Background:
      The majority of patients (pts) with non-squamous non small cell lung cancer (NSq/NSCLC) present inoperable disease for which no curative disease exists. The combination of Carboplatin(CBDCA), Paclitaxel(PTX) and Bevacizumab(BEV) is one of the standards 1st line treatment for this group of pts without EGFR sensitizing mutation or ALK gene rearrangement. The aim of the study was to evaluate the effectiveness and safety of the combination of CBDCA, PTX and BEV in pts with NSq/NSCLC consecutively admitted and treated in our Dept between 03/2010 and 12/2015.

      Methods:
      In a total of 50 pts,37 men(74%),13 women(26%), median age 68 (47-82) and ECOG 1 (0-4), heavy smokers 42/50(84%), with no mutation of EGFR and ALK, were treated with CBDCA (AUC =5), PTX 175mg/m2, BEV 7.5 mg/Kg, every 3 weeks, and primary prophylaxis with G-CSFs d 1-10. The chemotherapy was repeated for a median of 4(1-11) cycles

      Results:
      The objective response was 36% (18/50), 27% for men and 61% for women (0.05 68 years (p = N.S.) respectively. The median PFS was 6+ (1-10+) months for women and 4(2-13) for men. The median OS was 9+ (3-30) months for women and 6(1-24) for men. One out of 50 pts experienced CR for 25 months. The toxicity of the treatment was estimated in a total of 210 cycles of chemotherapy. The most frequent adverse events grade III and IV were neutropenia 2/210 (0.95%), febrile neutropenia 1/210 (0.47%), anaemia 5/210 (2.38%) and thrombocytopenia 3/210 (1.43%). Reduction of doses were required only in 6 (12%) pts, in all cases after the 1st or the 2[nd] cycle of chemotherapy. Hospitalization was required for 4/50 (8%) of the pts., while 1/50 died during a toxic episode.

      Conclusion:
      In our unselected NSq NSCLC pts stages IIIb or IV: 1. The combination of CBDCA, PTX and BEV with G-CSF prophylaxis , was proved effective and very well tolerated independent of ECOG and age. 2. Women seemed to response better than men in this combination.

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