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Joydeep Ghosh



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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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      P1.12-19 - Clinico-Pathological Characteristics and Treatment Outcome in Small Cell Lung Cancer: A Single Institutional Experience (ID 11314)

      16:45 - 18:00  |  Author(s): Joydeep Ghosh

      • Abstract
      • Slides

      Background

      Lung cancer is one of the commonest cancer in the world with a high rate of mortality. Small cell lung cancer constitutes around 14% of all lung cancers. Literature on small cell lung cancer is scarce in literature. The aim of the study was to analyze clinical profile of patients with lung cancer and their treatment outcome.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This is a single institutional data review of patients treated between June 2011 and Dec 2017 with diagnosis of small cell carcinoma of lung. Patients were staged as either localized or extensive disease after appropriate staging work-up. Patients with localized disease were treated with concurrent chemo-radiation with platinum based chemotherapy. Those with extensive disease were treated with platinum based palliative chemotherapy. Clinic-pathological characteristics, treatment details and outcome were recorded in this study. Response assessment was done using RECIST criteria wherever applicable. Patients who received at least 1 cycle of palliative chemotherapy were included for survival analysis.

      4c3880bb027f159e801041b1021e88e8 Result

      Total 128 patients were registered with median age of 62 years (range: 38-86), male:female ratio of 115:13. The ECOG performance status was 0 in 2, 1 in 30 (23%), 2 in 64, (50%) 3 in 29 (22%) and 4 in 3 patients. Ninety-percent (n=112) patients had smoking history and 20% (n=25) patients had symptom of superior vena cava obstruction at baseline. Eleven (9%) patients had localized disease at presentation. Sixteen (12.5%) patients had brain metastasis at presentation. Eighty-two (64%) patients took palliative chemotherapy and eight (10%) of them had localized disease. Chemotherapy regimen was – carboplatin only in 5 (6%), etoposide-carboplatin in 29 (35%) and cisplatin-etoposide in 48 (58%). Patients received median cycle number of 6 (range:1-6). Of the evaluable 58 (71%) patients, initial response was complete response in 2, partial response in 37, stable disease in 15 and progressive disease in 4. Fifteen patients received second-line chemotherapy on progression of disease. After a median follow-up of 6.7months (range: 0.3 - 36.6), median progression-free survival was 8.6 months.. After a median follow up of 12.5 months (range:0.3-36.6), median overall survival was 8.7 months.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Small cell carcinoma in our series had high incidence of advanced stage (91%) and 10% patients were non- smoker. Only 64% patients received palliative chemotherapy and achieved high disease control rate (>90%) in the evaluable patients with median progression-free survival of 8.6 months and median overall survival of 8.7 months.

      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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      P3.01-07 - Outcome and Prognostic Factors in ALK+ve Metastatic Adenocarcinoma of Lung: Single Center Experience From Eastern India (ID 12186)

      12:00 - 13:30  |  Author(s): Joydeep Ghosh

      • Abstract
      • Slides

      Background

      Anaplastic lymphoma kinase (ALK) positive metastatic adenocarcinoma of lung constitutes 3-5% of all lung cancers. Outcome of this small sub-group improved substantially over last few years with discovery of many ALK-inhibitors. Indian patients scarcely represented in the registration trials of ALK-inhibitors. Here, we report our experience of clinic-pathological characteristics, treatment outcome & prognostic factors in ALK-positive metastatic adenocarcinoma of lung

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This is a single institutional review of patients treated between Oct’13 and Feb’18. ALK was assessed by Ventana immunohistochemistry and/or fluorescent-in-situ hybridization analysis. Response assessment was done by RECIST v1.1. Patient who received at least one cycle of chemotherapy or one month of ALK-inhibitor was assessed for survival analysis in a modified intent-to-treat analysis

      4c3880bb027f159e801041b1021e88e8 Result

      Seventy-eight patients were registered with median age of 53 years (range: 24-82). Baseline features and treatment details are mentioned in Table 1. After median follow-up of 15 months (range: 1-53), median overall survival (OS) was 52.2 months (95 CI: 37.2 – not reached) and median progression-free survival (PFS) was 17.8 months (95 CI: 13.1-24.2). Median OS was 37.2 months & not reached whereas median PFS was 14.2 months & 22 months in patients treated with upfront chemotherapy (n=24) and with upfront ALK-inhibitor (n=32), respectively. 2ndline PFS was 22.6 months among patients (n=13) treated with 2nd line treatment. On multivariate analysis, gender (p=0.007) and upfront treatment regimen (p=0.001) emerged as independent prognostic factors for PFS whereas performance status (p=0.02) and upfront treatment regimen (p=0.01) showed significance for OS.

      Table 1: Baseline clinical characteristics & treatment details (n=78)

      Characteristics

      Number

      Percentage (%)

      Median (range)

      Age (years)

      53 (24 – 82)

      Sex

      Male

      Female

      47

      31

      60

      40

      Smoking status (n=74)

      Never smoker

      Current smoker

      Former smoker

      45

      26

      03

      61

      35

      04

      Symptom duration (months)

      1.5 (0.2 – 12)

      Eastern Cooperative Oncology Group performance status

      PS 1

      PS 2

      PS 3

      PS 4

      36

      29

      11

      02

      46

      37

      14

      03

      Tumor size (cm) n=44

      4.1 (0.9 – 12.2)

      Nodal status (n=63)

      N1

      N2

      N3

      03

      32

      28

      05

      51

      44

      No of involved organ metastasis

      Single

      Two

      Three

      Four

      Five

      19

      24

      20

      11

      04

      24

      31

      26

      14

      05

      Brain metastasis

      Yes

      No

      20

      58

      26

      74

      Treatment taken

      Yes

      No

      56

      22

      72

      28

      Upfront treatment type (n=56)

      Chemotherapy

      Chemotherapy f/b crizotinib

      Crizotinib

      Ceritinib

      24

      11

      18

      03

      43

      20

      32

      05

      Treatment response (n=44)

      Ccomplete response

      Partial response

      Stable disease

      Progressive disease

      02

      23

      17

      02

      4.5

      52

      39

      4.5

      Site of progression (n=21)

      Brain

      Lung/pleura

      Others

      10

      08

      03

      48

      38

      14

      2nd line treatment (n=13)

      Chemotherapy

      Crizotinib

      Ceritinib

      02

      03

      08

      15

      23

      62

      8eea62084ca7e541d918e823422bd82e Conclusion

      Primary tumor size was small with higher nodal burden and brain metastases in our cohort. Outcome was excellent with use of ALK-inhibitors in our series. Female sex and upfront use of ALK-inhibitors showed superior PFS whereas as good performance status and upfront use of ALK-inhibitors showed superior OS.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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