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Konstantinos Syrigos



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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: 3
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.01-61 - EGFR and KRAS Mutational Status and Significance in Greek Patients with Advanced Non Small Cell Lung Cancer (ID 13174)

      12:00 - 13:30  |  Author(s): Konstantinos Syrigos

      • Abstract
      • Slides

      Background

      KRAS mutations are reported in 20-25% of non-small cell lung cancer (NSCLC); their prognostic role in advanced NSCLC is still under dispute. Given that ethnicity may play a role on mutational profiles of NSCLC, we report here on KRAS mutations in Greek NSCLC patients.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      KRAS and EGFR genotypes were evaluated in 424 NSCLC patients diagnosed from March 2000 to December 2012 and associated with clinicopathological parameters. Outcome comparisons were performed in 234 metastatic patients with available treatment data, following 1st line chemotherapy without tyrosine kinase inhibitors.

      4c3880bb027f159e801041b1021e88e8 Result

      KRAS mutations were found in 71 tumors of all histologies (22.2% in adenocarcinomas); most common types were p.G12C (39.5%), p.G12D (32%) and p.G12V (14%). EGFR mutations were found in 45 tumors (14.8% in adenocarcinomas; 72.6% of the classical type) and were mutually exclusive with KRAS mutations except for one case. At a median 3-year follow-up for all patients, KRAS status was a strong negative prognostic factor for overall survival (OS, p=0.0213) but not for progression-free survival (PFS), irrespective of mutation type. KRAS mutations conferred 64% increased risk of death in all 1st line treated patients and the worst OS compared to EGFR and any wild-type status in 1st line platinum-treated patients (p=0.0547). Rare EGFR mutations conferred significantly better outcome to platinum-treated patients (OS, p=0.0074; PFS, p=0.0338).

      8eea62084ca7e541d918e823422bd82e Conclusion

      The presence of KRAS mutations seemed of adverse prognostic significance for survival, also in the presence of platinum-based 1st line treatment, while no prognostic differences were seen among different types of mutations.

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      P3.01-94 - Safety and Efficacy of First-Line Pemetrexed Versus Bevacizumab-Containing Regimens in Advanced Non-Small Cell Lung Cancer (ID 12179)

      12:00 - 13:30  |  Presenting Author(s): Konstantinos Syrigos

      • Abstract

      Background

      Previous trial data have documented the efficacy of first-line bevacizumab-based regimens, including bevacizumab-pemetrexed combinations in advanced non-small cell lung cancer (NSCLC). We herein aimed to further assess the safety and efficacy of pemetrexed monotherapy versus bevacizumab-containing or other chemotherapy regimens in a real-world NSCLC population.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      The medical records of 753 patients with advanced-stage non-squamous NSCLC, treated with bevacizumab-based regimens, pemetrexed monotherapy, or other treatments, as first-line therapy, were retrospectively reviewed and analyzed for efficacy and safety endpoints.

      4c3880bb027f159e801041b1021e88e8 Result

      The bevacizumab-based group had the highest percentage of partial response/PR (32.3% vs 22.8% for pemetrexed and 20.0% for other treatments) and a significantly lower incidence of progressive disease/PD (35.92%, 30.17%, and 50.48%, for pemetrexed, bevacizumab-based, and other, respectively; p < 0.0001). Bevacizumab-based regimens achieved a better overall survival (OS) rate (measured at the end of treatment) (pemetrexed 29.6%, bevacizumab-based 35.7%, and other treatments 8.9%; p < 0.0001). However, median OS was not improved (10 months, 12 months, and 13 months for pemetrexed, bevacizumab-based, and other treatments, respectively; p=0.007). A significantly higher incidence of cough (p = 0.001) and hemoptysis (p < 0.0001) in the bevacizumab-based arm, pain in the pemetrexed arm (p = 0.007), and alopecia in the other treatments arm (p < 0.0001) was observed during treatment. A significantly higher incidence of hemoptysis in the bevacizumab-based arm (p < 0.0001) and alopecia in the other treatments arm (p < 0.0001) was seen at the end of first-line treatment.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Bevacizumab-based regimens resulted in improved treatment response and short-term survival rate, but not in improved OS. An increased, albeit acceptable, toxicity was also observed among bevacizumab-treated patients as compared to those treated with pemetrexed monotherapy.

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      P3.01-95 - EGFR Genotype as a Predictor of Survival in EGFR Mutant Non-Small Cell Lung Cancer (ID 12177)

      12:00 - 13:30  |  Presenting Author(s): Konstantinos Syrigos

      • Abstract

      Background

      Patients with epidermal growth factor (EGFR)-mutant non-small cell lung cancer (NSCLC) represent a distinct treatment and prognostic subgroup, typically responding to treatment with tyrosine-kinase inhibitors (TKIs) but also displaying a highly variable prognosis. We herein aimed to further investigate the potential value of EGFR genotype as a predictor of survival in EGFR-mutant NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      The medical records of 68 patients with NSCLC and positive EGFR mutation status, who had been treated with EGFR-TKIs, were retrospectively reviewed. Demographic, clinicopathological features and EGFR mutation testing results of patients were correlated with survival.

      4c3880bb027f159e801041b1021e88e8 Result

      (EGFR) exon 19 E746-A750 deletion and (EGFR) exon 21 L858R point mutation were the commonest EGFR mutations, observed in 58% and 24% of patients, respectively. Median progression-free survival (PFS) among patients with (EGFR) exon 21, 19 and 18/20 was 22.9, 13.9 and 4.7 months, respectively. Median overall survival (mOS) for the above subgroups was 25.1, 35.8 and 13.8 months, respectively. The presence of (EGFR) exon 21 L858R point mutation was correlated with reduced risk of disease recurrence as compared to (EGFR) 18/20 mutations (HR=0,25, p=0,018); patients with (EGFR) exon 19 mutations had reduced risk of death as compared to those with (EGFR) exon 18/20 mutations (HR=0,29, p=0,007).

      8eea62084ca7e541d918e823422bd82e Conclusion

      The presence of (EGFR) exon 19 mutations may be associated with increased OS among patients with EGFR-mutant NSCLC.

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