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J. Kim



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    Poster Display Session (ID 63)

    • Event: ELCC 2017
    • Type: Poster Display Session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1
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      12P - Thyroid transcription factor-1 as a prognosticator in patients with metastatic lung adenocarcinoma without EGFR sensitizing mutations (ID 335)

      12:30 - 13:00  |  Author(s): J. Kim

      • Abstract

      Background:
      Thyroid transcription factor-1 (TTF-1) expression is known not only as a diagnostic marker but also a good prognosticator among patients with lung adenocarcinoma. However, good prognosis of TTF-1 expression might be due to epidermal growth factor receptor (EGFR) sensitizing mutations because of the positive correlation between TTF-1 expression and EGFR mutations. The purpose of this study was to explore prognostic impact of TTF-1 expression according to EGFR sensitizing mutation status in lung adenocarcinoma.

      Methods:
      This is a retrospective analysis of patients with 1) stage IV lung adenocarcinoma having available TTF-1 immunohistochemistry result, 2) ECOG performance status 0-2, and 3) receiving systemic anti-cancer treatment. The data were extracted from the registry of Hallym University Sacred Heart Hospital in Korea, between March 2006 and March 2016.

      Results:
      Of the 697 patients with lung adenocarcinoma, 144 patients were included for analysis. The mean age was 65.2 ± 11.6 years (female; 42.4%). EGFR sensitizing mutations were detected in 72/144 (50.0%) patients. TTF-1 was positive in 116/144 (80.6%) patients, and it had a significant correlation with EGFR sensitizing mutations (p < 0.001). Patients with TTF-1 positive lung adenocarcinoma had longer overall survival (OS) than TTF-1 negative (21.4 vs. 6.5 months, p < 0.001). In Cox regression analysis, TTF-1 positivity (hazard ratio [HR] 0.50; 95% CI: 0.31-0.83; p = 0.007), Stage IV, M1a (HR 0.62; 95% CI, 0.40–0.97; p = 0.034), good performance status (ECOG=0; HR 0.52; 95% CI, 0.33–0.82; p = 0.005) and EGFR sensitizing mutations (HR 0.62; 95% CI, 0.39–0.97; p = 0.038) were independently associated with prolonged OS. In the subgroup of patients with wild type EGFR adenocarcinoma, TTF-1 positivity was also good prognosticator for OS (HR 0.58; 95% CI: 0.33-0.99; p = 0.046), and for progression-free survival (PFS) of the first-line cytotoxic chemotherapy (HR 0.43; 95% CI, 0.24–0.78; p = 0.006). (Table).rnTable: 12PCox proportional hazard model of overall survival for 72 patients with lung adenocarcinoma harboring wild type EGFRrn

      rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn
      CovariateUnivariate analysisMultivariate analysis
      P valueHR (95% CI)P valueHR (95% CI)
      Age < 70 vs. ≥ 700.9860.995 (0.607-1.633)0.5631.175 (0.680-2.030)
      Female vs. male0.0060.425 (0.231-0.780)0.4700.563 (0.119-2.676)
      Never smoker vs. ever smoker<0.0010.443 (0.248-0.790)0.9800.981 (0.222-4.330)
      Stage IV, M1a vs. M1b0.0620.602 (0.353-1.027)0.0460.569 (0.327-0.991)
      ECOG 0 vs. 1-20.0160.529 (0.316-0.887)0.0760.587 (0.325-1.057)
      TTF-1 positive vs. negative0.0600.607 (0.360-1.022)0.0460.575 (0.334-0.991)
      Pemetrexed, 1[st] line vs. non-pemetrexed containing regimen0.8620.956 (0.576-1.587)0.4800.829 (0.492-1.395)
      rnHR=Hazard ratio; CI=confidence intervals, ECOG = Eastern Cooperative Oncology Group; EGFR = epidermal growth factor receptor; TTF-1 = thyroid transcription factor 1.rn

      Conclusions:
      TTF-1 expression was a good prognosticator for OS and PFS in patients with stage IV lung adenocarcinoma without EGFR sensitizing mutations.

      Clinical trial identification:


      Legal entity responsible for the study:
      Hallym University Sacred Heart Hospital Institutional Ethics Committee

      Funding:
      N/A

      Disclosure:
      All authors have declared no conflicts of interest.