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Jorge Arturo Alatorre Alexander
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P2.06 - Mesothelioma (Not CME Accredited Session) (ID 955)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 2
- Moderators:
- Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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P2.06-29 - Expression of Estrogen Receptor Beta (ERb) and its Prognostic Value in the Pleural Mesothelioma. (ID 13907)
16:45 - 18:00 | Author(s): Jorge Arturo Alatorre Alexander
- Abstract
Background
Overexpression of estrogen receptors in malignant pleural mesothelioma has shown to be a good prognostic marker of survival and the use of selective estrogen receptor beta agonists (ERb) increases the susceptibility to antitumor treatment.
a9ded1e5ce5d75814730bb4caaf49419 Method
Longitudinal,retrospectiveand unicentric study that analyzes the response of malignant pleural mesothelioma with an expression of ERb to chemotherapy in the first line. The study had 22 patients pathologically diagnosed with malignant pleural mesothelioma between April 2014 to September 2015 at the National Institute of Respiratory Diseases, who underwent immunohistochemistry for ERb (mouse monoclonal antibody PPG5/10), used a qualitative system determined by direct observation of the pathologist with a scale 1+ for weak staining and 3+ for very intense staining, as well as the percentage of expression, was considered as high when it was increased to 50% of the cells. The primary endpoint was overall survival and ERb expression variable; secondary outcomes were progression-free survival and response rate to chemotherapy based on RECIST 1.1.
4c3880bb027f159e801041b1021e88e8 Result
The sample is formed by 13 men (59.1%) and 9 women (40.9%), with a clinical stage of IV in 54.5%, III in 36.4%, II and IA both with 4.5%. Were smokers 54.5% with an average of 5.9 packs/year. In 95.5% there was an epithelioid pattern and 3.5% was biphasic. The 77.2% of the patients expressed a high percentage ERband 22.8% a low or null percentage. The response to the treatment by RECIST 1.1 was 54.5% for partial response (12 patients), stable disease in 22.7% (5 patients) and progression 13.6% (3 patients), no patient had a complete response. Of the patients who had a partial response, 75% (9 patients) had a high percentage of ERb expression in the tumor cells and 25% had a low or null percentage. The progression-free survival of patients with high ERbexpression had a median of 12.2 months compared to 9.3 months with low or null expression (p = 0.67, 95% CI 4.5 - 12-9), overall survival was 19.5 months in those with high expression of the receptor and 10.3 months for patients with low or null expression (this had a greater tendency to be higher in the ERb high expression for 9.2 months) (p = 0.054, 95% CI 9.79-10.01)
8eea62084ca7e541d918e823422bd82e Conclusion
ERb high expression in patients with an advanced clinical stage of malignant pleural mesothelioma was associated with a better response to chemotherapy treatment (without being statistically significant), with a better progression-free survival and possibly overall survival trend.
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P2.06-30 - Association of Histopathological Patterns of Mesothelioma and Response to Treatment with Chemotherapy (ID 13799)
16:45 - 18:00 | Author(s): Jorge Arturo Alatorre Alexander
- Abstract
Background
Mesothelioma is a neoplasm with a high mortality, there are different prognostic factors that influence survival, within these, the histological type has been associated directly.
a9ded1e5ce5d75814730bb4caaf49419 Method
Descriptive, observational, retrospective and unicentric study, that analyzes the response of the different histopathological patterns of malignant pleural mesothelioma to chemotherapy. The study had 28 patients pathologically diagnosed with malignant pleural mesothelioma between April 2014 to August 2015 at the National Institute of Respiratory Diseases. The primary objectives were overall survival and mesothelioma histopathological patterns variable, and secondary objectives was progression free survival and response rate to chemotherapy based on RECIST 1.1.
4c3880bb027f159e801041b1021e88e8 Result
The sample was formed by 18 men (64%) and 10 women (36%), 57% had asbestos exposure and 43% another exhibition (textile, fiber glass, cement, fertilizer, petroleum, solvents and coal). The 46% were smokers with an average of 6.6 packs/year. The method of biopsy as a diagnostic was thoracoscopy, which was used in 57% of the patients. The 94.4% had epithelioid pattern and 3.6% biphasic; in the epithelioid pattern, the solid subtype was the most predominant with 51.8%, followed by tubulopapillary with 14.9%, acinar with 14.8%, papillary and micropapillary both with 7.4% and pleomorphic with 3.7%. In overall survival and progression-free survival were higher the subtypes: micropapillary with 27 months, solid with 23 and 20 months, tubulopapillary with 20 and 18 months and acinar with 15 and 17 months respectively, the poorer prognosis was pleomorphic subtype with 4 months, similar to the biphasic pattern with 6 months. The median progression free survival for all patients was 17 months, the men were higher to the women with 17 and 12 months respectively. We found a relationship between overall survival and the nuclear calretinin, with a better prognosis for that patients who are not expressers (27.3 months) comparative to that patients with any level of expression (17 months). Within the therapeutic schemes used in the first line, by permetrexed plus cisplatin was superior to others in the disease-free survival; in the compound of platinum, the combined with cisplatin proved to be superior, not influencing the therapeutic scheme in the overall survival.
8eea62084ca7e541d918e823422bd82e Conclusion
The histopathological pattern is a prognostic factor in progression free survival and overall survival. Nuclear calretinin is a prognosis factor. The best therapeutic scheme of front line was permetrexed plus cisplatin in progression free survival, cisplatin schemes offer a better PFS compare to carboplatin schemes, not influencing in the overall survival.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.13 - Targeted Therapy (Not CME Accredited Session) (ID 979)
- 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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P3.13-20 - Frequency of EGFR Mutations in Patients with Adenocarcinoma Lung Cancer. Comparative Study Between Public and Private Mexican Health Services (ID 13965)
12:00 - 13:30 | Author(s): Jorge Arturo Alatorre Alexander
- Abstract
Background
The frequency of the EGFR mutation in pulmonary adenocarcinoma varies between 15-40% depending of population reported. Study descriptive, observational, retrospective and multicentric was conducted to determine the frequency of this mutation in public and private centers service in Mexico
a9ded1e5ce5d75814730bb4caaf49419 Method
They were selected patients with diagnosed of pulmonary adenocarcinoma between January 2011 and January 2016 from three oncology centers, two private centers (ABC Medical Center and the Spanish Hospital) and one public (National Institute of Respiratory Diseases). The total sample was 328 patients, subdivided by the presence or not of EGFR mutations. The primary objective was the mutation in EGFR and the secondary the type of mutation, frequency by sex, type of treatment and clinical stage at the time of diagnosis.
4c3880bb027f159e801041b1021e88e8 Result
The sample was formed by 136 (41%) men and 195 (59%) women, the average age of diagnosis was 62.4 years, the clinical stage in 75.7% was IV at the time of diagnosis. The total frequency of the EGFR mutation was 42.7% (140 patients), the most prevalent being Del19 (66.4%) and L858R (30%). These mutations were present in 113 patients of INER (34.5%) and by both private centers was 27 patients (8.2%), this difference was significant when comparing hospital types (public vs. private, p 0.033). Men showed a protective factor for the EGFR mutation compared to women with HR 0.88 (p 0.028), there were differences between the possibility of presenting the EGFR mutation in patients with lung cancer, with less possibility of presenting it if medical attention was done in a private medium compared to the public medium with a HR 0.81 (p .001).
8eea62084ca7e541d918e823422bd82e Conclusion
There is a significant difference in the frequency of mutations in EGFR between the public and private hospital, probably associated with ethnic, genetic, environmental and social differences between the two populations.
6f8b794f3246b0c1e1780bb4d4d5dc53
