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G.C. Khilnani
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Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Track:
- Presentations: 2
- Moderators:
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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41P - Gender based variations in presentation and management of lung cancer at a south Asian tertiary referral centre (ID 447)
12:30 - 13:00 | Author(s): G.C. Khilnani
- Abstract
Background:
The clinical presentation and management strategies of lung cancer for lesser income women in South Asia has rarely been evaluated. We sought to compare the baseline characteristics, duration of symptoms, histology, staging, and rates of treatment between women and men at our public tertiary referral center in northern India.
Methods:
A retrospective review of patients diagnosed with lung cancer between January 1, 2008 and December 31, 2016 was completed. Baseline variables, previous treatment for tuberculosis, length of symptoms, tumor characteristics, and forms of treatment were collected and compared between women and men.
Results:
1370 total patients were selected including 230 females (16.8%). Compared to men, women were younger (mean {SD} age, 54.6 {10.9} vs. 58.4 {10.8}; p < 0.001), less likely current or previous smokers (34.1% vs. 86.1%; p < 0.001), had a lower rate of secondary education (46.3% vs. 69.4%, p < 0.001), and increased rate of previous tuberculosis treatment (37.3% vs. 29.6%, p = 0.03). No differences in duration (p = 0.47) of symptoms at time of diagnosis, rates (p = 0.92) of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), or rates (p = 0.20) of ultimately receiving some form of cancer treatment between women and men were observed. Women had higher rates of stage IV disease (75.0% vs. 62.2%, p < 0.001) for NSCLC but shared no difference (p = 0.48) in rates of extensive stage for SCLC compared to men.
Conclusions:
Women with lung cancer in our region are younger, more likely non-smokers, less well educated, more likely to have received recent anti-tuberculosis therapy before being correctly diagnosed, and more likely to present with metastatic disease. Clinicians should maintain a high index of suspicion even in younger women presenting with new-onset respiratory symptoms which may mimic tuberculosis.
Clinical trial identification:
Legal entity responsible for the study:
N/A
Funding:
Has not received any funding
Disclosure:
All authors have declared no conflicts of interest.
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54P - Epidermal growth factor receptor expression (EGFR) in serum as a marker of treatment response and survival in advanced squamous cell lung cancer (ID 353)
12:30 - 13:00 | Author(s): G.C. Khilnani
- Abstract
Background:
Reliable biomarkers are needed to prognostigate patients with advanced lung cancer following chemotherapy. This study evaluated the association of serum EGFR expression with disease severity and treatment response in advanced Squamous cell lung cancer.
Methods:
Newly diagnosed subjects with advanced Squamous cell lung cancer (stage IIIB and IV) were enrolled. Relevant demographic data were recorded, including performance status (assessed by Karnofsky performance status [KPS] and European Co-operative Oncology Group [ECOG] scoring system). Epidermal growth growth factor receptor (EGFR) expression was estimated in serum using reverse transcriptase polymerase chain reaction (RT-PCR) at baseline and following four cycles of Carboplatin – Paclitaxel chemotherapy. Response was assessed using the RECIST 1.1 criteria. Objective response rate (ORR) was defined as Complete remission (CR) or partial response (PR) and Disease control rate (DCR) was defined as CR/PR/Stable disease (SD). Kaplan meier curve was used to compare the overall survival (OS) between subjects based on median EGFR expression level as the cut-off.
Results:
A total of 82 subjects were enrolled. These included 79 (96.3%) males with mean (SD) age of 61.9 (9.8) years and 48.8% having metastatic disease. Majority were current / former smokers (97.6%); 59.7% had KPS ranging between 40 -70 and 48.1% had ECOG of 0/II. The baseline mean (± SD) serum EGFR expression was 17.8 ± 9.3 fold increase over control values, with median (min., max.) of 18.2 (4.4, 42.8). Following chemotherapy, ORR and DCR were 59.7% and 77.3% respectively. Significant reduction in EGFR expression was observed with median (min, max.) absolute and percentage reduction of 6.2 fold (−3.1, 33.6), and 54.2 % (−55.6, 78.4) respectively; p < 0.001. No significant association was observed between change in EGFR expression and age, gender, disease stage, performance status, ORR or DCR. Subjects with baseline EGFR expression of greater than 16.0 fold had significantly worse OS than those with <16.0 fold increase.
Conclusions:
EGFR is over-expressed in advanced squamous cell lung cancer and is significantly down-regulated following chemotherapy; additionally, baseline expression is a useful marker of overall survival following chemotherapy.
Clinical trial identification:
Legal entity responsible for the study:
N/A
Funding:
Department of Biotechnology, India
Disclosure:
All authors have declared no conflicts of interest.
