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N.C. Pereira

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    P1.01 - Advanced NSCLC (ID 757)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P1.01-020 - Translocation ALK/EML4+ in Non-Squamous NSCLC Population and Crizotinib: What Can We Tell? (ID 10379)

      09:30 - 16:00  |  Author(s): N.C. Pereira

      • Abstract
      • Slides

      Molecular analysis when managing a patient with lung cancer is important. This importance seems never stop increasing as the methods of testing are improving and our knowledge specially concerning therapeutic is expanding. In patients with non-small cell lung cancer (NSCLC) translocation anaplastic lymphoma kinase/echinoderm microtubule-associated protein-like 4 (ALK/EML4) is identified in 3-5% and those patients have their own epidemiology. Studies concerning ALK/EML4 are still few in Portugal but this is changing with new treatments, such as Crizotinib. The aim of our study was to analyse NSCLC ALK/EML4+ to find out their features and treatment responses to Crizotinib.

      Retrospective study of 340 non-squamous NSCLC patients followed in our Thoracic Tumours Unit between 1 January of 2012 and 31 May of 2017. The translocation ALK/EML4 was analysed by FISH test. From ALK+ group an epidemiology characterization (age, gender, perform status and smoking habits) was made and were selected the ones treated with Crizotinib. From this last selection the adverse effects were registered and the progression free survival (PFS) was studied throw a Kaplan–Meier method.

      The population included: 12% (41) patients ALK+, 68% (230) ALK- and 20% (69) inconclusive. Patients ALK+ were constituted by 51.2% women and 56% of non-smokers, with average age of 64 years old. Of this subgroup 20 patients were treated with Crizotinib: 45% as 1[st ]line, 45% as 2[nd] line, 5% as 3[rd] line and 5% as 4[th] line of treatment. The response obtained was: 10% with partial remission, 35% with stable disease, 20% with progressive disease and 35% non-evaluated; no one achieved complete remission. The median of PFS was 273 days (± 111 days). Lateral effects were registered in 70% of the patients, the main ones being: nausea (25%) and elevations of transaminases (25%). Other side effects were visual alterations (15%), bradycardia (5%) and others (25%). Because toxicity 3 patients suspended Crizotinib.

      Lung oncology is reaching more and more a molecular level. However, the inadequacy of the samples and other errors are limiting the tests, as here is stand out by 20% of inconclusive results. Our study revealed a prevalence of ALK+ higher than is described in literature (12%), although the epidemiology is in concordance (majority of women and non-smokers). Under Crizotinib PFS is similar as previous described data (9,1months). In sum, more is yet to be known and improved.

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