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Gilda Santos



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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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      P2.01-94 - Diagnostic Patterns of Non-Small Cell Lung Cancer at Princess Margaret Cancer Centre (ID 14178)

      16:45 - 18:00  |  Author(s): Gilda Santos

      • Abstract
      • Slides

      Background

      Accurate classification of lung cancer subtypes has become critical in tailoring lung cancer treatment. Our study aimed to evaluate changes in diagnostic testing and pathologic subtyping of advanced non-small cell lung cancer (NSCLC) over time at a major cancer centre.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A review of patients diagnosed with advanced NSCLC at the Princess Margaret Cancer Centre between 2007-2009 and 2013-2015 was performed. Diagnostic method, sample type and site, pathologic subtype, and use of immunohistochemical (IHC) staining and molecular testing were abstracted.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 238 patients were reviewed in 2007-2009 and 283 patients in 2013-2015 (Table 1). Over time, the proportion of patients diagnosed with adenocarcinoma increased from 60.9% to 73.1% while NSCLC-not otherwise specified (NOS) diagnosis decreased from 18.9% to 6.4%, p<0.0001. There was a decrease in use of diagnostic bronchoscopy (26.9% vs 18.4%) and an increase with mediastinal sampling procedures including endobronchial ultrasound (9.2% vs 20.5%), p=0.0001. A substantial reduction in cases reported as NSCLC-NOS was observed among bronchoscopy, image-guided, and mediastinal sampling procedures. The reduction in NSCLC-NOS was also predominantly seen in cytology samples, from 22.0% to 4.0% (p<0.0001).

      IHC use increased over time from 41.6% to 76.3% (p<0.0001). Patients with larger samples and IHC analysis were more likely to have biomarker testing performed (both p<0.01). Within the group diagnosed with NSCLC-NOS, the use of IHC increased non-significantly from 64% (29/45) to 94% (16/18). With the exception of bronchoscopy samples, use of IHC increased significantly with each method of diagnosis and sample type.

      table 1. patient demographics and diagnostic sampling characteristics.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      Customizing treatment based on pathologic subtype and molecular genotype has become key in treating advanced lung cancer patients. Greater accuracy of pathologic diagnosis is being achieved including through use of routine IHC.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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