Virtual Library

Start Your Search

Tzippy Shochat



Author of

  • +

    P1.04 - Immunooncology (Not CME Accredited Session) (ID 936)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
    • +

      P1.04-17 - Tumour Burden as a Predictive Tool of Response to Immune Checkpoint Inhibitors (ICI) in Patients with Metastatic Non-Small-Cell Lung Cancer (ID 12467)

      16:45 - 18:00  |  Author(s): Tzippy Shochat

      • Abstract
      • Slides

      Background

      ICI are a novel class of agents that have revolutionized treatment for patients with metastatic non-small-cell lung cancer (NSCLC). Still, most patients do not benefit from PD-1 axis inhibitors, emphasizing the need for additional markers beyond PDL-1 expression for better selection of patients.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This retrospective, single centre study included all consecutive patients with advanced NSCLC who were evaluated with a FDG-PET scan prior to first administration of an ICI (nivolumab or pembrolizumab) between 1/2016 and 6/2017. Tumour burden was calculated using the total body Metabolic Tumour Volume (MTV) and the sum of all measurable lesions (SOML) with accordance to the RECIST criteria. This study received IRB approval.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 58 patients with histologically proven NSCLC were included. Patients had a median age of 65 years (43-84), 59% were male, 62% had adenocarcinoma and 83% were previously treated with chemotherapy. The median PFS for the entire cohort was 5.7 (1-15.8) months, and the ORR for ICI was 44.8%.

      The median MTV was 12.95 (0-236) millimeter³ and was significantly and inversely associated with longer PFS (p=0.036, 95%CI 1-1.015). The median SOML was 88 (13-305) centimetres, and was significantly and inversely associated with a longer PFS and higher ORR (PFS: P=0.004, 95% CI 1.002-1.011, ORR: OR 0.993 p=0.0067(.

      Additionally, patients with a SOML under 56 CM (first quartile) had a longer PFS compared to patients with a higher disease volume (Table1).

      SOML

      (CM)

      Median PFS

      (months)
      P value
      (compared to 1st quartile)
      1st quartile 56 12.1 -
      2nd quartile 88 5.1 0.017
      3rd quartile 115 4.23 0.036
      4th quartile 305 3.15 0.01

      table 1: some of measurable lesions (in centimeters) and PFS in metastatic NSCLC pateints recieving ICI

      8eea62084ca7e541d918e823422bd82e Conclusion

      In our study, a high tumour burden in patients with advanced NSCLC treated with ICI was associated with a shorter PFS and a lower ORR. This association warrants further prospective evaluation in order to optimize treatment.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    P2.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 961)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
    • +

      P2.12-14 - Stereotactic Radiosurgery for Brain Metastases in Small Cell Lung Cancer. (ID 13726)

      16:45 - 18:00  |  Author(s): Tzippy Shochat

      • Abstract
      • Slides

      Background

      Prophylactic cranial irradiation (PCI) omission in favor of brain magnetic resonance imaging (MRI) staging and surveillance in the management of small cell lung cancer (SCLC) is controversial yet accepted by some centers policy. The latter strategy implies stereotactic radiosurgery (SRS) treatment (Tx) for limited brain metastases (BM). Data regarding SRS efficacy in this setting is limited.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Ten consecutive SCLC patients (pts) with BM treated with SRS at Davidoff Cancer center between Aug 2012 and July 2017 were identified through the institutional database; pts receiving PCI or whole brain radiotherapy (WBRT) as a primary intervention were excluded. Brain MRI images were reviewed by neuro-radiology specialist. Intracranial objective response rate (IORR), progression-free survival (IPFS), intracranial failure patterns, overall survival (OS) and time-to-WBRT/death whichever occurred first (TTWD) were analyzed.

      4c3880bb027f159e801041b1021e88e8 Result

      Baseline pt characteristics are presented in the Table. SRS dose ranged from 16 Gy to 22.5 Gy. IORR comprised 57% by RECIST 1.1 and 60% by mRECIST 1.1. Intracranial progression developed in 8 pts; median IPFS was 3.9 mo (95% CI, 1.7-7.2). In-site, off-site and combined pattern of intracranial failure was seen in 0, 6, and 2 pts, respectively; median number of new BM per disease course was 2 (range, 1-11). Nine additional rounds of SRS were delivered in 6 pts (median number of lesion irradiated per round-1, range, 1-5). WBRT was ultimately administered in 3 pts; 4 pts died. Median TTWD comprised 23.2 mo (95% CI, 1.9-26.8). Median OS since SRS administration was 23.2 mo (95% CI, 4.2-26.8).
      table 1.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      MRI surveillance combined with multiple rounds of SRS in case of limited BM development might provide reasonable alternative to PCI or therapeutic WBRT in SCLC. SRS in SCLC warrants prospective evaluation.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.