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Susama Patra
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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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P3.01-21 - Metastatic Lung Carcinoma —An Institutional Experience from Eastern India (ID 13260)
12:00 - 13:30 | Author(s): Susama Patra
- Abstract
Background
Carcinoma lung carries poor prognosis and is the leading cause of death among all malignancies.In developing countries like India,two-third of patients present with advanced stage of disease,where survival is dismal.Hence a retrospective study was planned to be conducted to observe the clinicopathological profile of patients presenting with metastatic lung carcinoma and to analyse the treatment response and survival in these cases.
a9ded1e5ce5d75814730bb4caaf49419 Method
A retrospective analysis was done from hospital files of patients with metastatic carcinoma lung presenting to our hospital from January 2015 to April 2018.
4c3880bb027f159e801041b1021e88e8 Result
Out of 55 patients of metastatic lung carcinoma ,36(65%) were male and 19(35%) were female.Majority of the patients were of elderly age group >60yrs i.e 47%(36patients),followed by 40-60yrs age group i.e 31%(17 patients).Considering laterality of primary malignancy,right lung was more commonly affected than left lung(60% vs 40%).Histopathologically adenocarcinoma was the most common variety encountered(85.45%,47 patients) followed by squamous cell variety(0.9%,5 patients).Among 47 patients of adenocarcinoma variety,20 patients(42.5%)have EGFR mutations,whereas 27 patients(57.5%) were EGFR nonmutated.The pattern of metastases shows single organ metastasis in 19 patients(34.5%) and multiple organ metastases in 36 patients(65.5%). Overall bone was the most common site(25 patients) of metastases whereas brain was the most common single organ metastasis site.The followup period ranged from 2months to 40 months(median followup period-7mnths).One year and two year overall survival was 30% and 10.9% respectively.Subgroup analysis between patients who have received Tyrosine Kinase Inhibitors(TKI)±chemotherapy group and those who have received chemotherapy only group showed median overall survival of 19 months vs 6mnths respectively.
8eea62084ca7e541d918e823422bd82e Conclusion
Inspite of increased awareness,incidence of metastatic lung carcinoma is still high.Adenocarcinoma is the most common histopathological variety.Bone,contralateral lung and brain were the common organs involved by metastases.EGFR mutation status should be assessed in all cases of adenocarcinoma lung.Adding TKI in EGFR mutated cases has shown increased survival in our study.Larger sample size and longer followup period can further validify the results.
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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P3.13-16 - Concomitant EML4-ALK Rearrangement and EGFR Mutation in Non-Small Cell Lung Cancer Patients: Data from Eastern Indian Hospital. (ID 13867)
12:00 - 13:30 | Author(s): Susama Patra
- Abstract
Background
Clinical guidelines recommend routine testing for genetic mutations in all adenocarcinoma of lung, including ALK EML4 gene rearrangement. The coexistence of EGFR mutations and EML4- ALK rearrangements have been described as extremely rare. Perhaps this is due to its low prevalence and the sensitivity of available diagnostic modalities. All India Institute of Medical Sciences, Bhubaneswar, is an upcoming institute of national importance situated in eastern India. No report on EGFR mutation and EML4- ALK rearrangement has been published so far from this region of India.
a9ded1e5ce5d75814730bb4caaf49419 Method
We retrospectively analysed the available data of patients from June 2014 to April 2018. Genetic testing was done from tissue block specimens immediately after establishing the histology. EGFR mutation analysis were done using commercially available Real Time PCR and ALK-positivity was assessed with immunohistochemistry (IHC) by VENTANA ALK (D5F3) CDx Assay. We investigated the course of disease with the efficacy of targeted therapy in EGFR/ ALK co-altered NSCLCs
4c3880bb027f159e801041b1021e88e8 Result
Out of 251 NSCLC cases, 198 had adenocarcinoma and only four patients (1.6%) had concomitant EGFR/ALK co-alterations. Of the EGFR mutations, two were positive for Exon 19 and other two were positive for Exon 21. Mean age for Exon 19 and Exon 21 positive patients were 40 and 63 respectively. All four patients were male and had advanced stages of lung cancer. Mutation in all the four patients were detected from initial tissue biopsy and they were negative for ROS1. Three patients had received platinum based doublet regimen followed by EGFR-TKI and one patient received Erlotinib. None had received Crizotinib yet.
8eea62084ca7e541d918e823422bd82e Conclusion
The coexistence of EGFR mutations and EML4- ALK rearrangements is low but higher than other geographical areas. Since the two alterations may coexist from the beginning of diagnosis, future perspective in management could be finding potential efficacy of a double inhibition of both ALK and EGFR mutations.
6f8b794f3246b0c1e1780bb4d4d5dc53
