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Mehmet Kucukoner



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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): Mehmet Kucukoner

      • 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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    P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.01-49 - Comparision of Radiotheraphy Concurrent Weekly Treatment in Locally Advanced Unresectable Non Small Cell Lung Cancer (ID 13171)

      16:45 - 18:00  |  Author(s): Mehmet Kucukoner

      • Abstract
      • Slides

      Background

      Despite concurrent chemoradiotheraphy is standard treatment of unresectable locally advanced non small cell lung cancer (NSCLC),optimal chemotheraphy regimen is still inconclusive. Radiotheraphy concurrent weekly chemotheraphy has been studying and due to less toxicity it is preferred. In this study, we aimed to compare two weekly different regimens in terms of outcome and toxicity .

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We screened retrospectively 142 patients with stage III, locally advanced unresectable NSCLC, treated with radiotheraphy concurrent weekly platinum-paclitaxel ( PP) or platinum-docetaxel (PD ) between 2006 and 2017 years.Age, sex, stage, histologic subtype, response rates, survival and toxicity were analyzed. In RT concurrently PP arm 50 mg/m² paclitaxel and 20 mg/m² cisplatin or carboplatin AUC 2; in PD arm 20 mg/m² dosetaxel and 20 mg/m² cisplatin applied. Radiotheraphy applied as weekly 5 fraction/ 60-66 Gy. Treatment response classified progression and clinically responsive which consist of stable response (SR), complete response(CR) and partial response(PR).

      4c3880bb027f159e801041b1021e88e8 Result

      One hundred thirty one (92,3%) patients were man and median age was 62 (25-79). Histologic subtype was squamous cell carcinoma in 77 (54.2%) patients. At diagnosis 53 patients (37,3%) were stage IIIA, 89 (62,7%) patients were stage IIIB and IIIC. There were 102 patients in DP arm whereas 40 patients were in PP arm. Age, gender, stage and histologic subtypes were similar in both groups.There were no statistically significant in clinically response rates between two group (PD 96,1% vs PP 90% , p = 0.15) . Median overall survival (OS) was higher in PP arm than PD arm ( 29 vs 14,4 months ,p=0,018). Progression free survival (PFS) were same in both arms (15,6 vs 15,4 months p=0,522).There were no statistically significant in mucositis and eosophitis( 90% vs 80 %, p=0,418) and vomiting (10% vs 8,8%, p=0,931) in both arms. In PP arm neutropenia (p=0,000) and thrombocytopenia rates were higher (p=0,021). Pulmonary toxicity (p=0,053) and nausea (p=0,056) was higher in PP arm, which is closed to statistical significance. Although deaths due to treatment toxicity were not detected ,progression and other reason related death were more common in PD arm (p<0,001).

      8eea62084ca7e541d918e823422bd82e Conclusion

      In our study, despite clinical response and PFS were same in both radiotheraphy concurrent regimens in locally advanced unresectable NSCLC, OS was higher in PP arm. There are few study compared this two arms, which show no OS differences. Although it must be supported by prospective studies,OS is beter in PP arm than PD arm.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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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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      P3.01-52 - The Role of Serum Carcinoembryonic Antigen to Predict  the Response of Treatment in  Non‑Small Cell Lung Cancer Patients (ID 12446)

      12:00 - 13:30  |  Author(s): Mehmet Kucukoner

      • Abstract
      • Slides

      Background

      Imaging techniques are routinely used in non-small cell lung cancer (NSCLC) to monitor response to chemotherapy. Biomarkers have been investigated in NSCLC for monitoring treatment response. We have measured tumor marker levels at the time of diagnosis and response assessment. In this study, the change in serum carcinoembryonic antigen (CEA) levels and the association with treatment response was evaluated.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      One hundred patients with NSCLC diagnosed in our institution between 2013-2017 has been included retrospectively in this study. One hundred and thirty-five treatment responses were evaluated from 100 patients. Age, sex, stage, histologic subtype, tumor marker levels in the diagnosis, the change in serum CEA levels and the association with treatment response were analyzed. The treatment responses of the patients were evaluated as those with clinical response [stable response (SD) + complete response (CR) + partial response (PR)] versus progression disease (PD)] and relations with CEA level were assessed.

      4c3880bb027f159e801041b1021e88e8 Result

      Seventy-four (74%) patients were male, and the median age was 57.5 (23-83) years. Thirty-one (31%) were locally advanced and inoperable, and 68 patients (68%) were metastatic. Histologic subtype was adenocarcinoma in 73 patients (73%). At the time of diagnosis, median CEA level was 16.2 ng/ml (1.53-1.000), CA19-9 level was 16 U/ml (0.6-1611), CA 15-3 level was 42 U/ml (8.4-895) and CA 125 level was 70 U/ml (7-1111). There was a high baseline level of serum; CEA in 54 of 88 patients (61.4%), CA19-9 in 20 of 70 patients (28.6%), CA 15-3 in 29 of 39 patients (74.4%) and CA125 in 34 of 43 patients (79.1%) at the time of diagnosis. İn 135 evaluated responses; clinical response and progression were observed in 100 (74.1%) and 35 (25.9%) patient, respectively. CEA level was stable or decreased in 86/100 (86%) clinical responsive patients, while it was elevated in 26/35 (74.3%) progressive patients. The change in CEA level, predict response to therapy with 86% sensitivity and 74.2% specificity. The positive predictive and negative predictive value were calculated as 90.5% and 65%, respectively. The baseline level of CEA was not a prognostic factor.

      8eea62084ca7e541d918e823422bd82e Conclusion

      CEA levels were associated with treatment response in the previous studies and similar results were obtained in our study. CEA is readily detected in serum samples making it a valuable tool for the follow-up of patients and may better predict response to treatment.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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