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Deniz Tural
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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): Deniz Tural
- 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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P1.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 948)
- 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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P1.16-03 - Prognostic Significance of PD-L1 in Stage II/III Non-Small Cell Lung Cancer (ID 13025)
16:45 - 18:00 | Author(s): Deniz Tural
- Abstract
Background
Prognostic significance of PD-1/PD-L1 axis expression in non-small cell lung cancer (NSCLC) remains uncertain despite being a predictive biomarker for novel immunotherapeutics. In this study, we have investigated PD-1/PD-L1 expression and its effect on disease prognosis and overall survival in stage II-III NSCLC patients.
a9ded1e5ce5d75814730bb4caaf49419 Method
Clinic and pathologic features of stage II and stage III NSCLC patients were retrospectively analyzed from patients’ records in this study. PD-1 and PD-L1 immunohistochemistry staining were carried out to archived tumor specimens of the eligible patients. Percentages of PD-1 positive lymphocytes, PD-L1 positive tumor cells and PD-L1 positive tumor infiltrating immune cells were evaluated and considered as positive if ≥1% of the cells displayed staining.
4c3880bb027f159e801041b1021e88e8 Result
Sixty-six male (89,2%) and 8 female (10,8%) of total 74 patients were eligible for the study. Thirty-three (44,6%) patients were diagnosed as stage II disease while 41 patients (55,6%) were diagnosed as stage III. PD-1 expression, PD-L1 expression in tumor cells and PD-L1 expression in tumor infiltrating immune cells were positive in 83,8% (n = 62), 45,9% (n = 34), 67,6% (n = 50) of total 74 patients, respectively.Three-year overall survival (OS) rate was calculated as 57,7%. Univariate analyses did not reveal any significant difference in 3-years OS between those with PD-1 and PD-L1 expression in tumor infiltrating immune cells and those without expression. (p = 0,413 and p = 0,099; respectively) However, 3-years OS was more favorable in those with PD-L1 expression in tumor cells than in those without PD-L1 expression (76,6% vs %41%, p = 0.031). In multivariate analyses, a positive trend was revealed in 3-years OS between those with PD-L1 expression in tumor cells and those without expression. (HR: 0,405; 95% CI: 0,153, 1,074; p = 0,069)
8eea62084ca7e541d918e823422bd82e Conclusion
Conclusions: In this study, better prognosis was obtained with positivity of PD-L1 in tumor cells. Therefore, it should be taking into consideration while designing adjuvant immunotherapy trials which are generally formed with stage I-III NSCLC patients, that expression of PD-1/PD-L1 pathway may have a positive prognostic effect.
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