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Cheol-Kyu Park



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    P1.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 944)

    • 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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      P1.12-07 - Time to the End of Thoracic Radiotherapy Affects to Survival Outcomes Greater than Radiation Dose in Limited Stage Small Cell Lung Cancer (ID 13607)

      16:45 - 18:00  |  Author(s): Cheol-Kyu Park

      • Abstract
      • Slides

      Background

      Early thoracic radiotherapy (TRT) concurrent with chemotherapy and radiation doses of 45 Gy given 1.5 Gy bid still has taken a seat as a standard treatment option for limited-stage small cell lung cancer (LS-SCLC). We aim to search the association between radiation parameters and survival outcomes in LS-SCLC patients who undertaken more than 45 Gy of TRT.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      One hundred and one patients with LS-SCLC who completed TRT between August 2005 and March 2014 were reviewed retrospectively. Median age was 64 years (43-80) and male to female was 88 vs. 13. Stage IIIA was 30 and IIIB was 55, respectively. TRT was performed using 3-dimensional conformal radiation therapy (3DCRT) and delivered using 2Gy single fraction per day in 73.2% of patients. The median dose TRT was 50 Gy (45-65), and all patients received concurrent chemoradiotherapy. PCI was combined in 56 (55.4%) patients.

      4c3880bb027f159e801041b1021e88e8 Result

      The median survival for all patients was 26.9 months. Local failure occurred in 41 patients (40.5%), and distant metastasis was noted in 54 patients (53.4%). The 3-year local control, progression-free survival (PFS), and overall survival (OS) rates were 52.0%, 29.5%, and 56.4%, respectively. On univariate analysis, the American Joint Committee on Cancer stage (p<0.001), timing of TRT (≤2 vs, >2 cycles, p=0.017), tumor response (CR vs. PR, p=0.015), the duration from the start date of chemotherapy to the end of TRT (SER) (≤70 vs >70 days, p=0.025), and PCI (p=0.003) were the significant predictors of OS and stage (p<0.001) and PCI (p=0.017) were the significant predictors in PFS. Multivariate analysis revealed that stage (hazard ratio [HR], 3.61; 95% CI, 2.15-6.07) was the only significant factor in PFS and stage (HR, 2.49; 95% CI, 1.56-3.98), SER (HR, 1.93; 95% CI, 1.22-3.07), PCI (HR, 0.52; 95% CI, 0.33-0.84), and tumor response (HR, 1.76; 95% CI, 1.12 – 2.77) were the significant predictors in OS. There was one fatal radiation pneumonitis. Grade 3 radiation pneumonitis and esophagitis was shown in 7 (6.9%) vs. 7 (6.9%) patients, respectively. Grade 3 and 4 leukopenia was shown in 30 (29.7%) vs. 11 (10.8%) patients and febrile neutropenia was 9 (8.9%) vs. 1 (0.9%) patients, respectively.

      8eea62084ca7e541d918e823422bd82e Conclusion

      SER less than 70 days was a significant predictors of OS in LS-SCLC patients who received more than 45 Gy of TRT concurrently with chemotherapy. We could not find any significant positive survival benefits of TRT dose or BED escalation in our patients groups.

      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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      P3.01-77 - Clinical Characteristics of Korean Lung Cancer Patients with Programmed Death-Ligand 1 Expression (ID 12770)

      12:00 - 13:30  |  Author(s): Cheol-Kyu Park

      • Abstract
      • Slides

      Background

      Programmed death-ligand 1 (PD-L1) is a transmembrane protein that binds to the programmed death-1 (PD-1) receptor and anti-PD-1 therapy enables the immune response against tumors. The aim of this study was to assess the clinical and pathologic characteristics of PD-L1 positive lung cancer patients in Korea. And we examined correlation between immunohistochemical assays.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively reviewed the clinical and pathologic data of pathologically proven lung cancer patients, and collected 267 cases of formalin-fixed, paraffin-embedded tissue sample from single institution. PD-L1 expression was detected by qualitative immunohistochemical assay using Monoclonal Mouse Anti-PD-L1, Clone 22C3. PD-L1 protein expression is determined by using Tumor Proportion Score (TPS), which is the percentage of viable tumor cells showing partial or complete membrane staining. We categorized according to the percentage of TPS; more than 1% or more than 50%. Among 267 patients, 34 were analyzed by both 22C3 and SP263 assays. We examined the concordance correlation between IHC assays.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 267 patients were enrolled and major histologic types were adenocarcinoma (69.3%). The majority was smoker (67.4%) and clinical stage IV (60.7%). Thirty one (11.6%) cases of EGFR mutation and 17 (6.4%) cases of ALK FISH positive were included. The patients who showed TPS ≥ 1% and 50% were 116 (42%) and 58 (21%), respectively. More than 1% of TPS group was consisted of adenocarcinoma (67.8%), squamous cell carcinoma (29.6%), and small cell carcinoma (1.9%) histology. And more than 50% of TPS group was composed of adenocarcinoma (72.4%), squamous cell carcinoma (22.4%). More than 1% of TPS group was significantly older than less than 1% of TPS group (64.83 ± 9.38 vs. 61.73 ± 10.78 years, p=0.014). The rate of poorly differentiated pathology was significantly higher in TPS ≥ 1% group (40.8% vs. 25.8%) and TPS ≥ 50% group (53.2% vs. 27.2%). There was no difference in smoking, EGFR mutation, ALK rearrangement status or biopsy site. Among 34 patients analyzed by both 22C3 and SP 263, 27 patients showed positive by both 22C3 and SP263, at the cut-off of 1% or higher. The concordance correlation coefficient was 0.826 (95% confidence interval: 0.736-0.916).

      8eea62084ca7e541d918e823422bd82e Conclusion

      In Korean lung cancer patients, PD-L1 positive group defined as TPS ≥ 1% was older than negative group. And major histology was poorly differentiated non-small cell lung cancer in both TPS ≥ 1% and 50% groups. And our results showed a high correlation between PD-L1 IHC expression data analyzed by 22C3 and SP263 assays.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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