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Jose Maria Gutierrez Castañeda
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P1.06 - Epidemiology/Primary Prevention/Tobacco Control and Cessation (ID 692)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.06-022 - Prognostic Value of NLR in Overall Survival of Patients with Advanced Lung Cancer (ID 10478)
09:30 - 16:00 | Author(s): Jose Maria Gutierrez Castañeda
- Abstract
Background:
Lung cancer remains as the principal death cause in many regions around the world. Unfortunately, between 60-70% of patients are diagnosed with advanced disease (clinical stage IIIB-IV), that determinate the prognosis of patients. The high mortality rates of advanced lung cancer (ALC) are partly due to the lack of effective prognostic biomarkers. Recent investigations suggest that neutrophils-to-lymphocyte ratio (NLR) play an important role in the immune response to lung cancer, high value is considered as a prognostic indicator. We evaluated the prognostic value of NLR in overall survival (OS) of patients with ALC treated at a private institution (Oncosalud – AUNA).
Method:
We analyzed data of 75 patients with advanced lung cancer, treated at Oncosalud-AUNA between 2013 - 2014. The clinical-pathological data were collected from digital medical records. The laboratory data (hemoglobin, leukocytes, neutrophil, lymphocyte, and monocyte) were collected from blood routine test. Optimal cutoff value of NLR (<3.6 and >3.6) and LMR (<4.7 and >4.7) were calculated using the maximally selected rank statistics. OS was determinate using Kaplan-Meier method and survival curves comparison were performed using log-rank test or Breslow. Cox model was used to estimate the effect of NLR on overall survival.
Result:
The median age was 70 years (range: 39-91) and 49% of patients were women. The metastatic sites were brain (28%), osseous (18%), cervical and supraclavicular (14%). The 66.7% of patients received chemotherapy with/without radiotherapy, 9% radiotherapy only and 24% non-treatment. In patients previously treated with chemotherapy, 52% received targeted therapy. The median follow-up was 23 months (CI95%: 17-29), median survival was 9.6 months (CI95%. 5.6-13.5) and, 1 and 2 years survival rate were 38% and 23%, respectively. The survival rate at 1 and 2 years in those receiving targeted therapy were 65% and 43%, and those who did not receive were 35% and 10%. In univariate analysis, ECOG scale 2-4 (p = 0.001), leukocytes > 10,000 cell/uL (p = 0.031), neutrophil > 7500 cell/mL (p = 0.021), monocytes > 800 cell/mL (p = 0.027), NLR >3.6 (p = 0.001), LMR>4.7 (0.036) and CYFRA 21.2 > 3.3 ng/mL (p = 0.033) were associated with poor survival. However, in the Cox model only NLR was associated with poor prognosis (HR: 3.2, CI95%: 1.6-6.3)
Conclusion:
Overall survival for our patients is similar to other series. Patients under NLR e <3.6 had a relatively better prognostic.
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-053 - Outcome of Clinical Management of Elderly and Younger Patients with NSCLC Inside a Private Institution (Oncosalud-AUNA) (ID 10466)
09:00 - 16:00 | Presenting Author(s): Jose Maria Gutierrez Castañeda
- Abstract
Background:
Most non-small cell lung cancer patients (NSCLC) patients are older than 70 years and therefore their management is challenging as it may be complicated by an increased number of comorbidities and greater risk of treatment-related complications. For these reasons, elderly patients tend to be undertreated. Our objective was to evaluate the efficacy of treatment in this population in comparison with younger patients.
Method:
Retrospective study of patients with unresectable stage IIIB and stage IV NSCLC diagnosed between 2011 and 2014 at Oncosalud AUNA, a private specialized cancer center, which were treated with chemotherapy. Data was collected from clinical files. Type of treatment among young and elders (>70) was compared, as well as benefit from treatment, in terms of objective response rate (ORR), progression free survival (PFS) and 1-year overall survival (OS).
Result:
83 patients were included (70.8% young, 29.2% elder). There were no significant differences in gender, among the 2 groups (male 56.1 vs 57.7% p= 1.00), histology (86% vs 82%, p=0.972), ECOG 2-3 (19% vs 30.8% p=0.383), metastatic disease (70.2% vs 69.2% p=0.16), brain metastases (15.8 vs 3.8%, p=0.16), for younger and elder, respectively. The both groups received same combinations treatment, the monotherapy in both groups was 7% vs 11.5% (p= 0.672). Carboplatin and pemetrexed was the most frequent chemotherapy regimen (56% vs 57% p=1.00) respectively. The cisplatin based regimens was (15.8% vs 7.7% p=0.489). The benefits of treatment were similar, regardless of age, ORR was 52.6% vs 46%(p 0.65). At 21 months of follow up, PFS was 5.5 vs 4.9 months (p=0.52), respectively. The 1-year OS was 19.2% and 5% respectively (p=0.199).
Conclusion:
In our clinical practice, the elderly tend to be treated the same. Treatment efficacy is similar among both groups. If medically fit, patients should be treated the same, regardless of age.
