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Perran Fulden Yumuk
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P1.01 - Advanced NSCLC (Not CME Accredited Session) (ID 933)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.01-45 - Crizotinib Efficacy in ALK-Positive Advanced Stage Non-Small Cell Lung Cancer Patients: A Real-World Experience from Turkey (ID 14012)
16:45 - 18:00 | Author(s): Perran Fulden Yumuk
- Abstract
Background
ALK mutation is observed in 4% of patients diagnosed with NSCLC. The present study aimed to evaluate the efficacy of crizotinib, an ALK inhibitor, and clinical characteristics of ALK-positive NSCLC patients.
a9ded1e5ce5d75814730bb4caaf49419 Method
In this multicenter, retrospective study, data of ALK-positive advanced stage NSCLC patients who received crizotinib were retrieved from hospital records.
4c3880bb027f159e801041b1021e88e8 Result
Data of 353 ALK-positive metastatic NSCLC patients receiving crizotinib in any treatment line were analyzed. The mean age of the patients was 53.2±12.6 years [median, 53 years (21-85 years)] and 193 (54.7%) patients were male. Age at diagnosis was significantly higher in males than in females (54.8±11.8 years and 51.3±13.2 years, respectively; p=0.044). The rate of patients who never smoked was 50.1%. The most common histological subtype was adenocarcinoma (96%). The frequency of brain metastasis at the time of diagnosis was 23.4%. The most common initial symptoms were cough (56%) and dyspnea (53%). Initial ECOG score was 0 or 1 in 80% of the patients. Crizotinib had been used in 37% of the patients in the 1st-line treatment, in 45% of the patients in the 2nd-line treatment, and in 18% of the patients in the ≥3rd-line treatment.
Table 1. Response rates of the patients
Treatment line
Overall
N (%)1
N (%)2
N (%)3
N (%)Other
N (%)Complete response
28 (7.9)
9 (7.3)
14 (8.9)
4 (9.8)
1 (5.6)
Partial response
217 (61.5)
78 (62.9)
103 (65.2)
25 (61.0)
10 (55.6)
Stable disease
50 (14.2)
18 (14.5)
21 (13.3)
7 (17.1)
4 (22.2)
Progressive disease
67 (13.3)
19 (15.3)
20 (12.7)
5 (12.2)
3 (16.7)
Undefined
11 (3.1)
ORR
245 (69.4)
87 (70.2)
117 (74.1)
29 (70.8)
11 (61.2)
DCR
295 (83.6)
105 (84.7)
138 (87.4)
36 (87.1)
7 (83.4)
Undefined
11 (3.1)
ORR was 69.4% and DCR was 83.6% (Table 1). ORR and DCR in the patients received crizotinib were 70.2% and 84.7% in the 1st-line treatment, respectively and were 74.1% and 87.4% in the 2nd-line treatment, respectively. The frequency of brain metastasis was 40.2% at 12 months. Of these patients, the median PFS and OS were 11.3 and 28.0 months, respectively.
The most common side effects were fatigue, visual disturbances, nausea, abdominal discomfort, and pretibial edema.
8eea62084ca7e541d918e823422bd82e Conclusion
Clinical characteristics of ALK-positive patients and crizotinib efficacy are consistent with studies. Response rates and survival outcomes are similar regardless of treatment lines. Crizotinib is safely used in these patients.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.16-48 - Is Preoperative SUV(Max) of Primary Tumor a Predictor of Relapse for Operable Non-Small Cell Lung Cancer? (ID 12355)
12:00 - 13:30 | Presenting Author(s): Perran Fulden Yumuk
- Abstract
Background
Positron emission tomography-computed tomography (PET / CT) is currently recommended to rule out metastatic disease in non-small cell lung cancer (NSCLC), even in early stage patients. In this study, our aim is to evaluate the effect of maximum value of standardized uptake values (SUVmax) of primary tumor in PET/CT before surgery on relapse in operable NSCLC.
a9ded1e5ce5d75814730bb4caaf49419 Method
Data from 191 operable stage I-III NSCLC patients who had preoperative PET/CT was retrospectively analyzed between 2006-2018. Demografic and clinicopathologic findings were analyzed.Patients were staged according to TNM 8th edition. ROC curve analysis was performed to determine the ideal cut-off value of preoperative SUV max to predict relapse. The findings were analyzed using SPSS.
4c3880bb027f159e801041b1021e88e8 Result
At the time of diagnosis, median age was 62 years (39-82) and 84% of patients were male. Eighty-nine percent of our patients were smokers and smoking rate in males was 98%. Most common pathologic subtype was adenocarcinoma (Table 1). Mean follow-up duration was 35 months (1-128 months). Fourty-seven percent recurred and median progression free survival time (PFS) was 45 months (29-60 months). Median overall survival (OS) was 80 months.The ideal cut-off value of preoperative SUVmax that predicted relapse was 10.75 in the ROC analysis [AUC: 0,58 (0,50-0,66) p<0,05 with a sensitivity of 65%, and specificity of 57%]. Median PFS was 89 months in patients with preoperative SUVmax ≤ 10.75, and 34 months in patients with SUVmax > 10.75 (HR= 1.69; 95% CI 1.09-2.61; P =0.01).
Table 1 Demographic and clinicopathological findings
Gender
Male
160 (%84)
Female
31 (%16)
Smoking
Yes
171(%89)
No
20 (%11)
Stage
Stage 1
(n=51)
Stage 1A1-A3
33 (%17)
Stage 1B
18 ( %10)
Stage 2
(n=78)
Stage 2A
17 ( %8)
Stage 2B
61( %32)
Stage 3
(n=62)
Stage 3A
53(%28)
Stage 3B
9 (%5)
Pathology Subtype
Adenocarcinoma
98 (%51)
Squamous cell carcinoma
81 (%42)
Others
12 (%7)
Adjuvant treatment (n=123)
Stage 1
5 (%4)
Stage 2
65(%53)
Stage 3
53 (%43)
Recurrences
Yes
90 (%47)
No
101 (%53)
Recurrence patterns
Local
15 (16 %)
Systemic
75 (84 %)
Status
Alive
131 (%69)
Ex
60 (%31)
8eea62084ca7e541d918e823422bd82e Conclusion
Approximately 30% of NSCLC patients are diagnosed at early stage. Although surgery is curative treatment in early stage, recurrences are common. Preoperative SUV(max) of primary tumor in PET/CT might be a predictor of postoperative relapse for operated NSCLC.
6f8b794f3246b0c1e1780bb4d4d5dc53
