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P. Boffetta
Moderator of
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Epidemiology and innovations in biomarker development (ID 42)
- Event: ELCC 2017
- Type: Poster Discussion session
- Track:
- Presentations: 9
- Moderators:P. Boffetta, S. Lantuejoul, R.A. Stahel
- Coordinates: 5/06/2017, 16:45 - 17:45, Room W
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Invited Discussant 17PD and 18PD_PR (ID 540)
16:45 - 17:45 | Author(s): P. Boffetta
- Abstract
- Presentation
Abstract not provided
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Invited Discussant 30PD_PR and 96PD_PR (ID 539)
16:45 - 17:45 | Author(s): R..A. Stahel
- Abstract
- Presentation
Abstract not provided
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Invited Discussant LBA3 and 95PD (ID 538)
16:45 - 17:45 | Author(s): S. Lantuejoul
- Abstract
Abstract not provided
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17PD - Patterns of lung cancer metastasis in the US population (ID 286)
16:45 - 17:45 | Author(s): M. Hendawi
- Abstract
Background:
Lung cancers mostly present at a clinically advanced stage. Predicting the invasiveness of tumors might help in planning treatment and prophylaxis. We aim to investigate the patterns of lung cancer metastasis and determine possible clinical predictors of those patterns in population based study.
Methods:
The records of all patients (2010-2013) were extracted from SEER database of the National Cancer Institute. Data was extracted to SPSS. Univariate and multivariate logistic regression were used for analysis.
Results:
We have identified 76254 (54.5%M, 45.5F) patients with metastatic lung cancer (2010-2013).17% were small cell tumors (SCLC), while 83% of tumors were non-small cell tumors (NSCLC). Tumor was found more frequently on the right (54%) than the left (38%), and was bilateral in 8% of cases. Our analysis showed that NSCLC had higher rates of metastasis to bone than SCLC (37% Vs 34%) (P < 0.001, 95% CI: 1.097-1.190), SCLC had higher rates of metastasis to liver than NSCLC (46% Vs 20%) (p < 0.001 95%CI: 0.27-0.29), both SCLC and NCLC had almost similar rates of brain metastasis at the time of diagnosis (25% Vs 26%, respectively) (P = 0.003, 95% CI: 1.024-1.120). Following adenocarcinoma and small cell, squamous cell histology was 3rd most common tumor histology for both brain and liver metastasis. Although rare, carcinoid tumor had high rates of metastasis to brain at diagnosis (44.8%). Predictors for liver metastasis were small cell and adenocarcinoma histology (p < 0.001, 95% CI:0 .245-0.304), Tumors with upper lobe location (P = 0.028, 95% CI: 0.839-0.990), and high grade tumors (P < 0.001, 95% CI: 1.334-1.618). Predictors for metastasis to brain were advanced age at diagnosis (P < 0.001, 95% CI: 0.970 -0.976), Adenocarcinoma and small cell histology (P < 0.001, 95% CI: 1.254-1.561), Lower lobe, and main bronchus locations (p = 0.004, 95% CI: 0.689-0.930), and tumors of higher grade (P < 0.001, 95%CI: 1.250-1.463).
Conclusions:
Lung cancer subtypes are associated with distinct patterns of metastatic spread. SCLC has significantly higher rates of liver metastases, while NSCLC has higher rates of bone metastasis. Further investigation needed to evaluate the role of primary tumor location on metastatic behavior of lung cancer.
Clinical trial identification:
Legal entity responsible for the study:
Mohamed Hendawi
Funding:
N/A
Disclosure:
The author has declared no conflicts of interest.
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- Abstract
Background:
The clinical and radiologic presentation of lung cancer in women differs from men, especially in Asia. The aim of this study is to identify potential gender-related differences of newly developed lung cancer and provide the optimal CT screening intervals for the patients who are managed in the health care center.
Methods:
Between January 2000 and February 2016, a total of 46,766 consecutive patients who underwent screening chest CT in Health Care Center at Asan Medical Center of Korea were retrospectively reviewed. During the study period, 282 patients (M:F=205:77) were finally diagnosed by lung cancer. Among them, lung cancers were detected by initial screening CT in 186 patients (excluded in this study), and 96 patients (M:F=85:11, age range M:F=62.7±12.9: 62.7±8.7 years, respectively) have been clinically diagnosed as newly developed lung cancers using subsequent screening CT follow-up. Using the 96 patients, CT screening intervals, stage, and pathology (with subtype and mutation) of cancers were evaluated and analyzed to find any gender-related differences.
Results:
In the 96 patients, mean age is not significantly different between genders. Most of the men were smokers (74/85, 87%). Adenocarcinoma is the most common type (36/85, 42%), followed by squamous cell carcinoma (35%), small cell lung cancer (18%), and others (5%) in men. All female patients were adenocarcinoma. The mean time interval of screening CT was relatively longer in women (5.6±3.1 years) than in men (3.6±2.4 years) (p=0.02). However, lung cancer stages are significantly higher in men. Minimum CT screening interval to detect stage I lung cancer was longer in women (5 years) compared to that in men (1 year).
Conclusions:
The interval of screening CT could be longer in women than men. To detect most of stage I lung cancer, a 3-year interval screening for women and 1-year interval for men are optimal in our study for minimizing radiation hazard and worry.
Clinical trial identification:
Legal entity responsible for the study:
None
Funding:
N/A
Disclosure:
All authors have declared no conflicts of interest.
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30PD_PR - Circulating immune-profile as predictor of outcome in NSCLC patients treated with nivolumab (ID 510)
16:45 - 17:45 | Author(s): M. Tiseo, M. Veneziani, F. Gelsomino, F. Facchinetti, P. Bordi, E. Rapacchi, A. Squadrilli, S. Buti, G. Missale, A. Ardizzoni
- Abstract
Background:
PD-1/PD-L1 axis blockade is of pivotal interest in NSCLC, where the relative antibodies have shown relevant activity. Detection of markers able to predict the activity of these treatments is an importance issue. The predictive role of PD-L1 evaluated by IHC is debated in NSCLC, also, considering that small biopsies or cytological specimens represent often the only tumor material available. This study aimed to assess a circulating immuno-profile as predictor of outcome in NSCLC patients treated with nivolumab.
Methods:
A peripheral blood immuno-profile evaluation was performed at three different times: At baseline (T0), after 2 cycles (T1) and after 4 cycles (T2) of Nivolumab in 54 advanced pre-treated NSCLC patients treated in an Expanded Access Program in two Italian institutions. Tumor assessment was performed after 4 cycles and every 2 months. FACS analysis of lymphocyte subpopulations [CD3, CD4, CD8, NK (CD56) and Treg (FOXP3)] was performed. In addition to changes in absolute number and % of these populations, they were also characterized for their functional and proliferative activity. Quali-quantitative leucocyte composition at baseline and its change during therapy were correlated with tumor response and overall survival.
Results:
Baseline Neutrophil-to-Lymphocyte Ratio, baseline NK count, lymphocyte count and CD4 variations during therapy showed a statistically significant prognostic role (p < 0.001; p = 0.012; p < 0.001; p = 0.010, respectively). Preliminary results on 31 patients with all 3 time-points samples, showed: A significant increase of NK cells and a significant decrease of CD4% from T0 to T2; a significant increase from T0 to T2 of NK subpopulation CD56dim (with reduction of CD56bright); considering two groups of patients (19 responders vs. 12 non-responders), a NK increase (overall and of CD56dim) and CD4% decrease was observed in responders and non-responders, respectively; absolute number and % of NK at baseline was statistically different in the two groups; absolute number and % of CD8+/PD1+ at baseline was significantly higher in responders vs. non-responders.
Conclusions:
These data show that it is possible to identify predictive peripheral immuno-biomarkers, such as NK and CD8, for nivolumab therapy in advanced NSCLC.
Clinical trial identification:
NA
Legal entity responsible for the study:
University Hospital of Parma
Funding:
AIRC
Disclosure:
All authors have declared no conflicts of interest.
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95PD - Diagnostic EGFR testing with ctDNA versus tumour in patients with advanced non-small cell lung cancer (NSCLC): The Royal Marsden experience (ID 412)
16:45 - 17:45 | Author(s): R. Kumar, D.P. Walder, J. Bhosle, T.A. Yap, M.E.R. O'Brien, S. Popat, L. Thompson, S. Macmahon, J. Palma, D. Gonzalez de Castro
- Abstract
Background:
EGFR inhibitors are approved for use in patients with EGFR mutant NSCLC. The cobas® platform is a companion diagnostic test used in clinical practice on tumour tissue, and is approved for ctDNA EGFR testing from plasma samples. We evaluated the diagnostic performance of this platform on ctDNA in a prospective single centre study.
Methods:
Patients diagnosed with advanced NSCLC at the Royal Marsden Hospital between November 2015 - November 2016 were included. Patients had to have tissue EGFR result available. Peripheral blood samples were collected in cfD tubes (Roche Molecular Solutions CA, USA) and analysed using the cobas® platform following manufacturer’s instructions.
Results:
201 samples were analysed; median age 68 years. 89% of patients had adenocarcinoma, followed by poorly differentiated carcinoma (4%), squamous cell carcinoma (3%), adenosquamous (2.5%) and other (1.5%). 30% of patients were never smokers, whereas 58% were ex-smokers and 10% were current smokers (2% unknown smoking history). 93% of patients had stage 4 disease, whereas 7% had stage 3 disease. 42% of patients had thoracic-only disease. 79% of patients had their tissue EGFR analysis performed on the cobas[®] platform (others included Illumina NGS (7.5%); Therascreen[TM] (1%)). 10% of patients did not have available tumour tissue. All plasma samples were tested on the cobas[®] platform. Concordance rate between ctDNA and tumor was 87%, with sensitivity 65%, specificity 98%, positive predictive value 95%, and negative predictive value 85%. Concordance rate in patients with an EGFR mutation was 55% for thoracic-only disease and 75% for extra-thoracic disease. The mean time to EGFR result was shorter for ctDNA than tissue (8.4 vs 11.2 days; P=0.07) with a ctDNA failure rate of only 2.4%. Two tissue failures resulted in an EGFR mutation being picked up in plasma (Exon 19 and T790M).
Conclusions:
We demonstrate that ctDNA can be used for diagnosis of an EGFR mutation in advanced NSCLC with excellent specificity, despite moderate sensitivity. The cobas[®] test for ctDNA should be incorporated into clinical practice to triage patient care.
Clinical trial identification:
Not applicable
Legal entity responsible for the study:
The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust
Funding:
Roche Molecular Solutions CA, USA
Disclosure:
T.A. Yap: Received research funding from Roche. S. Popat: Consultant to Roche and has received honoraria from Roche. J. Palma: Employee of Roche Molecular Solutions CA, USA. All other authors have declared no conflicts of interest.
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96PD_PR - Evaluation of non-classical response by immune-modified RECIST and efficacy of atezolizumab beyond disease progression in advanced NSCLC: Results from the randomized Phase II study POPLAR (ID 363)
16:45 - 17:45 | Author(s): A. Artal-Cortes, J. Mazieres, L. Fehrenbacher, A. Rittmeyer, A.I. Spira, K. Park, C. Lewanski, S. Liu, M. Ballinger, J. Vansteenkiste
- Abstract
Background:
Response patterns following cancer immunotherapy (CIT) treatment are often non-classical due to tumor immune infiltration and increase in tumor burden prior to response. As such, RECIST-based endpoints may not adequately predict the potential OS benefit with CIT. In an updated analysis of POPLAR, PFS and ORR improvement with atezolizumab (atezo) vs docetaxel (doc) was restricted to patients (pts) with high PD-L1 expression, whereas OS benefit was seen in the PD-L1–unselected ITT population (HR, 0.69; mOS 12.6 mo vs 9.7 mo with atezo vs doc), suggesting that many pts derive atezo benefit after radiographic progression.
Methods:
287 NSCLC (2L/3L) pts were randomized 1:1 to receive atezo (1200 mg IV q3w) until loss of clinical benefit or doc (75 mg/m[2] IV q3w) until PD per RECIST v1.1 (RECIST). The primary endpoint was OS; secondary endpoints included PFS and ORR per RECIST. Atezo arm pts were evaluated per immune-modified RECIST (imRECIST) and post-PD radiographic changes. Both arms were evaluated for OS post-PD (data cutoff, Dec 1, 2015; minimum follow-up, 20 mo).
Results:
Among 144 pts in the atezo arm, ORR per imRECIST vs RECIST was 17% vs 15%, disease control rate (CR+PR+SD) was 65% (imRECIST) vs 52% (RECIST) and mPFS was 4.3 mo (imRECIST) vs 2.7 mo (RECIST). In 61 atezo pts continuing treatment post-PD, 8% had a subsequent ≥ 30% decrease in target lesions relative to the time of PD, and 74% had a best change between +20% and −30%. mOS post-PD in both arms is shown (Table).
Conclusions:
Increased ORR and PFS per imRECIST vs RECIST in atezo pts highlight the utility of imRECIST as response evaluation criteria to assess efficacy of atezo/CIT. 82% of pts continuing atezo post-PD had subsequent stable ( ≤ +20% change) or decreased target lesions. The nearly 1-yr mOS in pts continuing atezo vs other treatment post-PD is suggestive of atezo benefit lasting beyond PD. Table.rnTable: 96PD_PRrnrn
rnrn rnrnPatients Receiving Therapy Post-PD per RECIST v1.1 rnn rnmOS from time of first RECIST v1.1 PD rnrn rnAtezo arm pts continuing atezo rn61 rn11.8 mo rnrn rnAtezo arm pts receiving non-protocol anti-cancer therapy rn30 rn9.2 mo rnrn rnrnDoc arm pts receiving non-protocol anti-cancer therapy rn46 rn9.7 mo rn
Clinical trial identification:
NCT01903993
Legal entity responsible for the study:
F. Hoffmann-La Roche Ltd/Genentech Inc., a member of the Roche Group
Funding:
F. Hoffmann-La Roche Ltd/Genentech Inc., a member of the Roche Group
Disclosure:
A. Artal-Cortes: Advisory boards for Roche, BMS, MSD and travel fees from Roche. A. Rittmeyer: Grants as an advisor or speaker from Astra Zeneca, BMS, Boehringer Ingelheim, Eli Lilly, Pfizer and Roche Genentech. K. Park: Consulting/advisory from Astellas Pharma, AstraZeneca, BI, Clovis Oncology, Lilly, Hanmi, Kyowa Hakko Kirin, Novartis, Ono Pharmaceutical, Roche; speakers\' bureau fees from BI; research funding from AstraZeneca. C. Lewanski: Consulting/Advisory: Roche, Celgene, Amgen. S. Liu: Employed by Genentech and holds Roche stocks. M. Ballinger: A Genentech employee and has Roche stock. All other authors have declared no conflicts of interest.
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LBA3 - Correlation between clinical outcomes of patients treated within the tailor trial and next-generation sequencing (NGS) results: Analysis of genes associated to KRAS mutations (ID 463)
16:45 - 17:45 | Author(s): M. Ganzinelli, M. Broggini, G. Sozzi, M. Moro, M. Marabese, E. Caiola, A. Busico, E. Bria, E. Rulli, M.C. Garassino
- Abstract
Background:
TAILOR (NCT00637910) was a phase 3 randomized trial comparing erlotinib over docetaxel in second line treatment in EGFR wild-type patients. The prognostic and predictive value of KRAS is still debatable. Taking advantage from the available tissue samples and clinical data of this trial, we performed sequencing of a customized gene panel in order to identify novel biomarkers and new potential therapeutic targets specifically associated to KRAS.
Methods:
NGS was performed on PGM Ion Torrent platform and involved 111 genes. 5% of frequency was used to define mutations. Association with clinical features or between genes was performed with non-parametric test. Cox regression model was used to define the prognostic role of mutated genes on survival.
Results:
188 out of 222 randomized patients had available tissue. 134 tissues were successfully sequenced. 3 were EGFR mutated, 47 were KRAS mutated (36%). 68 were in erlotinib arm and 63 in docetaxel arm. Biomarkers associated to KRAS were 21 LKB1 (16%) and 61 p53 (46%). Survival results are described in the table.rnTable: LBA3rnrnrnrnrnrnrnrnrn
rnrn rnrn PFS rnPFS rnOS rnOS rnrn rnUnivariate rnMultivariate rnUnivariate rnMultivariate rnrn rnrnHR (95%CI) p-value rnHR (95%CI) p-value rnHR (95%CI) p-value rnHR (95%CI) p-value rnrn rnKRASwt/LKB1wt rnreference rnrn rn rn rn rnKRASmut/LKB1wt rn0.76 (0.51-1.15) p 0.19 rn0.79 (0.51-1.22) p 0.29 rn0.78 (0.51-1.19) p 0.25 rn0.75 (0.49-1.17) p 0.21 rnrn rnKRASwt/LKB1mut rn1.42 (0.68-2.95) p 0.35 rn1.43 (0.67-3.08) p 0.35 rn1.69 (0.81-3.52) p 0.16 rn1.59 (0.75-3.4) p 0.23 rnrn rnKRASmut/LKB1mut rn1.18 (0.64-2.19) p 0.59 rn1.29 (0.67-2.49) p 0.45 rn1.32 (0.72-2.45) p 0.37 rn1.34 (0.69-2.61) p 0.38 rnrn rnKRASwt/tp53wt rnreference rnrn rn rn rn rnKRASmut/tp53wt rn0.80 (0.49-1.31) p 0.37 rn0.87 (0.51-1.46) p 0.86 rn0.88 (0.53-1.46) p 0.61 rn0.85 (0.50-1.46) p 0.56 rnrn rnKRASwt/tp53mut rn1.23 (0.79-1.91) p 0.35 rn1.41 (0.88-2.26) p 0.15 rn1.38 (0.88-2.16) p 0.15 rn1.55 (0.95-2.55) p 0.81 rnrn rnrnKRASmut/tp53mut rn1.07 (0.62-1.82) p 0.81 rn1.11 (0.64-1.94) p 0.70 rn1.14 (0.66-1.98) p 0.64 rn1.12 (0.63-1.97) p 0.70 rn
Conclusions:
In TAILOR, KRAS was not prognostic. The association with LKB1 and p53 does not affect prognosis, while LKB1 mutation could be a negative prognostic factor (HR = 1.39). Further research is needed to prospectively assess this pathway.
Clinical trial identification:
Legal entity responsible for the study:
Fondazione IRCCS Istituto Nazionale Tumori, Milan
Funding:
AIRC (Associazione Italiana Ricerca Cancro)
Disclosure:
All authors have declared no conflicts of interest.
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Prevention and smoking cessation (ID 13)
- Event: ELCC 2017
- Type: Specialty Session
- Track:
- Presentations: 4
- Moderators:P. Boffetta, V. Westeel
- Coordinates: 5/06/2017, 11:00 - 12:30, Room C
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Does smoking cessation improve survival in metastatic lung cancer? (ID 55)
11:00 - 12:30 | Author(s): V. Westeel
- Abstract
- Presentation
Abstract not provided
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Smoking and the risk of early lung cancer (ID 52)
11:00 - 12:30 | Author(s): H. Ashraf
- Abstract
Abstract not provided
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The e-cigarette: New data with longer follow-up (ID 54)
11:00 - 12:30 | Author(s): A. Stoebner-Delbarre
- Abstract
Abstract not provided
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The environmental factors we should address to reduce the incidence of lung cancer in non-smokers (ID 53)
11:00 - 12:30 | Author(s): P. Boffetta
- Abstract
- Presentation
Abstract not provided
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Author of
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Epidemiology and innovations in biomarker development (ID 42)
- Event: ELCC 2017
- Type: Poster Discussion session
- Track:
- Presentations: 1
- Moderators:P. Boffetta, S. Lantuejoul, R.A. Stahel
- Coordinates: 5/06/2017, 16:45 - 17:45, Room W
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Invited Discussant 17PD and 18PD_PR (ID 540)
16:45 - 17:45 | Author(s): P. Boffetta
- Abstract
- Presentation
Abstract not provided
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.
-
+
Prevention and smoking cessation (ID 13)
- Event: ELCC 2017
- Type: Specialty Session
- Track:
- Presentations: 1
- Moderators:P. Boffetta, V. Westeel
- Coordinates: 5/06/2017, 11:00 - 12:30, Room C
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The environmental factors we should address to reduce the incidence of lung cancer in non-smokers (ID 53)
11:00 - 12:30 | Author(s): P. Boffetta
- Abstract
- Presentation
Abstract not provided
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