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MA 01 - SCLC: Research Perspectives (ID 650)
- Event: WCLC 2017
- Type: Mini Oral
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
MA 01.07 - Lanreotide Maintenance in SCLC Expressing Somatostatine Receptors: Efficacy Results of Multicenter Randomized G04.2011 Trial (ID 8480)
11:00 - 12:30 | Author(s): A. Misino
SCLC is featured by both a rapid response and progression during/after standard upfront therapy. Thus, maintenance strategies emerged as potential treatment opportunities, although to date all drugs failed to significantly improve prognosis. SCLC cells harbor a neuroendocrine phenotype, frequently expressing somatostatine (SST) receptors. This study aimed to investigate the efficacy of somatostatine (SST) analogue Lanreotide (LAN) as a maintenance strategy for SCLC patients (pts) after response to standard upfront treatment.
A multicentre, randomized, open-label, no-profit national trial was conducted, randomizing (1:1) SCLC (limited/extended disease, L/ED) pts expressing SST receptors (by SST receptor scintigraphy) with objective response (CR or PR) after upfront platinum-based chemotherapy plus/minus radiotherapy to receive maintenance LAN 120 mg subcutaneously every 28 days, up to progressive disease (PD) for 1 year (Arm A), versus observation (Arm B). Primary end-point was 1-year Progression-Free Survival (PFS). Primary intention-to-treat (ITT) analysis was planned (power: 80%; 2-tailed alpha-error: 5%) after 47 PFS events.
Seventy-one pts (median age 66 [37-82]; male/female 72/28%; L/ED 39/61%; ECOG-PS 0-1/2 97/3%; previous best response CR/PR 6/94%) were randomized in 9 Italian centers. Median time from diagnosis and end-of-1[st] line to inclusion was 5.7 months (3-160) and 30 days (0-119), respectively. Median number of LAN doses and treatment duration (Arm A) was 4 (1-12) and 83 days (1-392), respectively. With a median follow-up of 9.4 months and 62 events, median PFS was 3.6 (95% CI 3.2-3.9) versus 2.3 months (95% CI 1.7-2.9), for Arm A and B (log-rank p=0.11; HR 1.51, 95% CI 0.90-2.50), with a 1-year PFS of 10.3% versus 7.3%, respectively. At the cox-proportional multivariate modelling, stage (ED versus LD, HR 2.88 [95% CI 1.64-5.04, p<0.0001) and treatment arm (B versus A, HR 1.63 [95% CI 0.97-2.72], p=0.06) were independent predictors for PFS. Median PFS of arm A and B was 7.0 [95% CI <1-13.5] and 3.8 months [95% CI <1-8.6] in LD pts (p=0.21), and 3.0 (95% CI 2.2-3.8) and 2.2 (95% 1.7-2.7) in ED pts (p=0.19). Median OS was 9.5 (95% CI 4.8-14.3) and 4.7 months (95% CI 1.7-16.6), for Arm A and B (log-rank p=0.47), respectively. LAN was well-tolerated: serious treatment-related adverse events were grade 3 abdominal pain and electrolyte disorder in overall 2 pts.
Although the primary end-point was not met, the overall efficacy of LAN as a maintenance strategy after response to standard upfront treatment for SCLC deserves future investigations, particularly in pts with LD.
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P3.06 - Epidemiology/Primary Prevention/Tobacco Control and Cessation (ID 722)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
- Presentations: 1
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
P3.06-003 - What Do the Children Think about Smoking and How Are They Helped in Prevention? (ID 8815)
09:30 - 16:00 | Author(s): A. Misino
Despite a lot of reports on the harmful effects of smoking on health, according to DOXA (Italian Institute of Health survey, 2016), most of people smoke the first cigarette between age 15 and age 17 (56.8%). The aim of this study was to evaluate the attitudes and knowledge of school-age children about cigarette smoking
Within the national primary prevention campaign “Questa non me la fumo” supported and promoted by WALCE we asked to teachers to administer a dedicated questionnaire to pupils. 724 questionnaires were analyzed between September 2016 and May 2017: 365 from 9 years-old primary-school pupils and 359 from 10 years-old Primary-school pupils ( 357 male: 49.3%).
66% of pupils believes that a program of intervention might be useful as prevention action; however, the perception about smoke is that harms only those who smoke, improves sports performances and can help to lose weight in 28%, 1.8% and 5.1 % of cases, respectively. Among the smoking disadvantages, pupils describe bad breath (74.3%) and yellow teeth (70.1%), without reporting hair and muscle damage. 82.2% of students declare "I will never smoke", but 7.8% of them "the curiosity to try". Considering the living environment, it resulted that 44% of parents, 20% of grandparents, 21% of teachers, and 8% of peers smoke; however, most parents talk of smoking damage to their children (72%). Answers to “In your opinion, is it possible to quit smoking?” are encouraging: 76.2% responded “Yes” while “No” in 23.8% of cases. According to age, the reason "to be cool" why starting smoking was reported in 48.2% and 55%, in the fourth and firth grade of Primary school, respectively. Other reasons frequently reported were: “to imitate adults” and “to try”. When asked, “What do you think is more dangerous for you?”, “smoking a cigarette” was the most frequent (78%) among heterogeneous responses such as to travel by hitchhiking or skydiving .
These results highlight the awareness of children about the deleterious effect of smoke on health, but areas of greatest vulnerability emerged, such as poor knowledge about the smoking effects on some parts of the body or the consequences of passive smoking. Notably, children live with adults (family and school educators) but also with peers who smoke and this is worrying if we consider that the main reason for adolescent to start smoking attitude is emulation. These data emphasize the need to implement specific prevention programs also in primary school.