Author of

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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

  • 26843

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    P2.01-45 - Mutational and Inflammatory Biomarkers for Lung Cancer Patients with Pleural Effusions (ID 13884)

    16:45 - 18:00  |  Author(s): Paul Stockhammer
    • Abstract
    • Slides

    Background
    

    Pleural effusion is often associated with the progression of lung cancer and the treatment options for patients with malignant pleural effusions are rather limited. The estimation of prognosis remains to be challenging and personalized therapeutic strategies require a set of validated biomarkers.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    87 lung adenocarcinoma, 27 squamous cell carcinoma and 8 neuroendocrine carcinoma patients with pleural effusions were treated in our department between July 2016 and April 2018. Preoperative C-reactive protein and white blood cell count was collected and their association with clinicopathological parameters and overall survival was calculated. KRAS, EGFR and ALK mutational status was available in advanced lung adenocarcinoma cases. The association of oncogenic mutations with the malignancy of effusion was also analyzed.

    4c3880bb027f159e801041b1021e88e8 Result
    

    39 of the 122 patients had malignant pleural effusions (32%). 64 patients had TNM stage IV disease. Importantly, high CRP (>5 mg/dl, HR: 14.7, CI95% 2.9-73, p=0.0011) but not high WBC (>9000 cells per microliter) was a strong predictor of shorter survival in lung cancer patients with pleural effusions. High CRP remained a significant prognosticator in lung cancer patients with benign effusions (HR: 21.5, CI95% 1.9-242, p=0.013). KRAS mutation was identified in 28% of the lung adenocarcinoma cases. There was a tendency for lower KRAS mutation incidence in the MPE subcohort when compared to BPE cases (16.6% vs 34.6%, p=0.15). Interestingly, 22% of patients had EGFR mutation and EGFR mutations were more frequent in lung cancer patients with malignant effusions when compared to benign effusions (OR 4.8, CI95% 1.2-19.9, p=0.029).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Oncogenic driver mutations may impact the development of malignant effusions in lung adenocarcinoma patients. Furthermore, our study indicates that the routinely available, circulating preoperative C-reactive protein level carries prognostic information. These findings suggest that oncogenic mutations and inflammatory biomarkers can further personalize therapeutic decisions and can contribute to the risk stratification of lung cancer patients with pleural effusions.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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