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D. Grapsa
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P1.01 - Advanced NSCLC (ID 757)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.01-044 - Detection of Circulating Tumor Cells Is Associated with Disease Burden in Patients with Advanced Non-Small Cell Lung Cancer (ID 9565)
09:30 - 16:00 | Author(s): D. Grapsa
- Abstract
Background:
Previous studies on the clinical value of circulating tumor cells (CTCs) enumeration as a predictor of prognosis in non-small cell lung cancer (NSCLC) have yielded controversial results. The purpose of this study was to further evaluate the prognostic relevance of CTC count in patients with advanced-stage NSCLC before and after first line chemotherapy.
Method:
A total of 43 patients with chemotherapy-naïve, advanced NSCLC and at least one available measurement of CTCs were enrolled in this single-center retrospective study. The presence of CTCs was evaluated by the use of the CellSearch System; CTC positivity was defined as ≥2 CTC in 7.5 ml of whole blood. CTC status was assessed at two different time points, i.e. at baseline (before administration of chemotherapy) and after completion of the first chemotherapy cycle. Baseline CTC count and its dynamic change between the above time points were correlated with clinicopathological features of patients, treatment response and survival, using univariate and multivariate regression analysis.
Result:
Eight (18.6%) out of 43 patients (mean age 67.1 ± 9.9 years, male/female ratio 39/4) harbored CTCs at baseline (mean 22.75 CTCs/patient, range: 2 - 108). Positive baseline CTC count was significantly associated with the presence of five or more metastatic sites (p=0.018). Response to treatment was recorded in 40.6% of patients and disease stabilization or progression in 59.4%. No significant associations were found between response or progression rates and baseline CTC counts (p=0.067 and p=0.083, respectively). On the contrary, progressive disease status and metastatic disease burden were significantly associated with the change in CTC count, (p=0.033 and p=0.035, respectively). No significant associations were found between survival (PFS or OS) and CTC count or the dynamic change of CTC status. Worse performance status (PS) and the presence of five or more metastatic sites were recognized as independent predictors of reduced PFS [HR=2.7; 95% CI: 1.1-6.8; p=0.035 and HR=2.9; 95% CI: 1.1-8.1; p=0.042, respectively], while PS was the only variable independently associated with OS (HR=16.9; 95% CI: 4.3-65.8; p<0.001).
Conclusion:
In our study, CTC count and the dynamic change of CTC status following chemotherapy administration were both associated with increased metastatic disease burden but not with PFS or OS. These data support the suggested role of CTCs in the metastatic cascade and underline the need for further validation of this candidate biomarker before its implementation into routine oncology practice.
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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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P2.01-039 - Erythropoiesis-Stimulating Agents for Chemotherapy-Induced Anaemia in Lung Cancer: Efficacy, Toxicity and Effect on Survival (ID 9576)
09:00 - 16:00 | Author(s): D. Grapsa
- Abstract
Background:
Erythropoiesis-stimulating agents (ESAs) are widely used for treatment of chemotherapy-induced anaemia (CIA) in patients with various solid tumors, mainly including lung cancer and gynaecological malignancies, but concerns regarding their potential effect on tumor growth and disease progression have been raised. We herein aimed to further investigate the efficacy, toxicity and correlation with overall survival (OS) of treatment with ESAs in a real-world cohort of lung cancer patients.
Method:
The medical records of all patients > 18 years old, with newly-diagnosed advanced-stage lung cancer (non-small cell lung cancer /NSCLC or small cell lung cancer/SCLC) and CIA, treated at the Oncology Unit of Sotiria Athens General Hospital from January 2007 to December 2016 were retrospectively reviewed. The ESAs administered in our cohort were epoetin alfa, epoetin zeta and darbepoetin alfa. Patients were stratified into two subgroups, according to use of ESAs (ESAs-treated vs. those not treated with ESAs). Demographic, laboratory and clinicopathological features, hematological response and toxicity, response to chemotherapy and overall survival (OS) of patients were compared between groups, using univariate and multivariate regression analysis.
Result:
A total of 138 patients (110 males/28 females; mean age ±SD : 66.4± 8.7 years) with baseline (pretreatment) hemoglobin (Hb) values <11 mg/dl and ECOG performance status (PS) 0-2 were included in final analysis. ESAs were administered in 70/138 patients (50.7 %). Age, sex, histological type of tumor (NSCLC vs. SCLC), baseline values of Hb and PS were evenly distributed between groups (p=0.672, p=0.155, p=0.078, p=0.01 and p=0.647, respectively). Hematological response rates and incidence of thromboembolic events were both increased in ESA-treated patients, albeit without reaching statistical significance (p=0.229 and p=0.288, respectively). Neither response to chemotherapy nor OS were found to be significantly correlated with use of ESAs (p=0.498 and p=0.119, respectively).
Conclusion:
According to our study results, administration of ESAs was not significantly correlated with hematological response, response to chemotherapy or OS. Furthermore, treatment of CIA with ESAs was, generally, well-tolerated, with no significantly increased risk of thromboembolic events. A trend for improved partial/complete hematological response and improved OS among ESA-treated patients in our cohort needs to be interpreted with caution. Further randomized trials and larger prospective studies are warranted to investigate the efficacy, toxicity and potential prognostic implications of CID treatment with ESAs in patients with lung cancer.
