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E. Martinez Moreno



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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
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      P1.06-013 - Latent Tuberculosis in Newly Diagnosed Lung Cancer Patients. An Spanish Prospective Study (ID 9599)

      09:30 - 16:00  |  Author(s): E. Martinez Moreno

      • Abstract

      Background:
      Lung cancer and tuberculosis (TB) share common risk factors and are associated with high morbidity and mortality. Coexistence of lung cancer and TB were reported in previous studies, with uncertain pathogenesis. The association between lung cancer and latent TB infection (LTBI) remains to be explored. In Spain the prevalence is higher compared to other European countries and there are a high emigration rates. The key objetive is to place value on the need to detect LTBI for assesment for prophylaxis in patients at risk of reactivation due to cancer and cancer treatments.

      Method:
      Newly diagnosed , treatment-naïve advanced lung cancer patients from October-December 2015 and from October-December 2016 were prospectively enrolled .The presence of LTBI was determined by QuantiFERON-TB Gold In-Tube (QFT-GIT). Demographic characteristics and cancer-related factors associated with LTBI were investigated.

      Result:
      A total of 67 lung cancer patients were enrolled. The patients demographics were: median age 64 years, 10 (15%) female and 58 (85%) male. Adenocarcinoma 50% (n=34) , 23% (n=16) squamous-cell carcinoma and small cell lung cancer 26% ( n= 18) The stage was IV in 71%(n=53) and III in 29% (n=20) These patients come from urban area in 16% of cases and rural areas in the 83% and the 82% (n=56) had history of smoking. The 79,4% % ( n= 54) of patients received chemotherapy and 16% ( n= 11) inunotherapy with Nivolumab. Among these patients including 23 % (n=16) LTBI,65% (n=44) non-LTBI, and 12% (n=8 ) QFT-GIT results-indeterminate cases. Out of these LTBI patients received Isoniazid chemoprophylaxis only 60% because of poor performance status. Adenocarcinoma had higher proportion of LTBI 64% vs 18 % for epidermoid and 18% for oat-cell At the time of database lock, the median of overall survival was only 6 months.

      Conclusion:
      Nearly a quarter of newly diagnosed advanced lung cancer patients in Toledo ( Spain) have LTBI. There is a lack of widely acceptable and established standards for screening for latent TB in patients undergoing treatment for active solid-organ malignancy. Perhaps is recommended screening all patients born in countries with endemic TB before beginning radiotherapy or chemotherapy to avoid TB reactivation.

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    P2.07 - Immunology and Immunotherapy (ID 708)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Immunology and Immunotherapy
    • Presentations: 1
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      P2.07-039 - Nivolumab Experience in Patients with Previously Treated Advanced Non Small Cell Lung Cancer (NSCLC) in Toledo, Spain (ID 9568)

      09:30 - 16:00  |  Author(s): E. Martinez Moreno

      • Abstract

      Background:
      Nivolumab is a fully human IgG4 programmed death-1 (PD-1), an immune checkpoint inhibitor antibody and it has demonstrated durable responses and tolerability in heavily pretreated patients with advanced NSCLC. This is an observational study to describe our experience with Nivolumab in previously treated patients with advanced NSCLC .

      Method:
      The aim of the study was to report the efficacy and safety profile of Nivolumab in pretreated patients with advanced NSCLC of our everyday clinical practice. The exploratory assessments include the progression-free survival (PFS) and overall survival (OS) and the rates of treatment related adverse events (AEs). Elegibility criteria included, histologically or citologically confirmed NSCLC clinical stage IIIB vs IV, evaluable disease, at least one prior therapy from January of 2016 to current date.

      Result:
      From January of 2016 to May of 2017 , a total of 46 patients were enrolled in the study from our Hospital. The patients demographics were: median age 64 years (47-77), 6 (14%) female and 38 (86%) male. El 61% (n=27) non squamous-cell and 39% (n=17) squamous-cell carcinoma. The stage was IV in 71%(n=53) and III in 29% (n=13) .All the stage III patients have been treated with concurrent chemoradiotherapy. 41 patients ( 93%) have received platinum-based therapy previously to Nivolumab : 22 ( 50%) combined with Premetrexed and 19 (43%) with other drugs. 72% (n=20) have been treated with 2 or more prior therapy lines. Among 48 patients evaluated the best response to Nivolumab was: 4% (n=2) complete response, 36%(n=34)partial response and 25%(n=11) disease stabilization At the time of database lock, the median of PFS with Nivolumab was 2.3 IC 95% (1.2-2.7) and OS was not reached. Grade 1-2 treatment related adverse events (AEs) occurred in 32% patients and the most common ones were endocrine 16% (n=7) and neumonitis 4% ( n=2) but there were one case isolated of grade 3-4 encephalitis, nephritis and hypophysitis. The 4% ( n=29) patients need to be admitted to the hospital due Nivolumab toxicity versus 16% due to chemotherapy toxicity.

      Conclusion:
      Early data from this study suggest that Nivolumab is effective and well tolerated in patients with pretreated advanced NSCLC but in our serie the toxicity was relevant with some patients