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Neeraj Arora
Author of
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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): Neeraj Arora
- Abstract
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
