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Mukremin Uysal



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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): Mukremin Uysal

      • 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.

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    P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

    • 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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      P3.01-33 - EGFR Mutation in Patients with NSCLC and Its Relationship Between Survival and Clinicopathological Features: An Update Analysis (ID 12510)

      12:00 - 13:30  |  Author(s): Mukremin Uysal

      • Abstract

      Background

      There has been important developments in NSCLC since the understanding of molecular pathways. The aim of the study is to find the EGFR mutation frequency and its correlation to survival and clinicopathological features. We reported our data in this subject three years ago. We aim to resubmit our updated data.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      In this multicenter study, 1352 NSCLC (adenocarcinoma) patients were included retrospectively to find out the EGFR mutation status with age, sex, performance status, histopathological diagnosis, smoking status and stage. Survival correlates were determined. The aim of the study was to find out the EGFR mutation status with all of the features in the database.

      4c3880bb027f159e801041b1021e88e8 Result

      The median age was 59 (24-87) years. Median follow-up time was 14 (2-117) months. 26,2 % were female. 85,2% were stage IIIB-IV and 86 % was adenocarcinoma. EGFR mutation frequency was 22,3 % including exon 19 (63,0%). There was no correlation between mutational status and age, performance status, and stage at diagnosis (p>0,05). However, there was a correlation between gender and, smoking.. (p= 0.000 and 0,000. respectively). The frequency of mutation in female patients was more pronounced in non-smokers/ex-smokers. In the group that can perform survival analysis (827 pts), median progression-free survival was 9 months and overall survival was 20 months. The overall survival was 27 (SE:5; 95% CI 17-36) months in EGFR positive cases whereas 19 (SE:1; 95% CI 16-21) months in EGFR negative cases (p=0,008). The multivariate analysis showed good performance status, early stage disease and presence of EGFR mutation as a prognostic factor (p<0,05).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our investigation shows that the EGFR mutation rate in our patient population with adenocarcinoma of the lung was higher than in Western countries population and was lower than the East Asian population. The determination of EGFR mutation will lead the pathway for a better treatment outcome and individualized therapy.

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