Virtual Library

Start Your Search

Anish Thomas

Author of

  • +

    P1.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 944)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
    • +

      P1.12-15 - Distinctive Clinical Characteristics of SCLC in Never-Smokers (ID 13328)

      16:45 - 18:00  |  Author(s): Anish Thomas

      • Abstract
      • Slides


      Epidemiologic data suggest that 3% of patients with SCLCs are never-smokers. A large population study is required to describe the characteristics and outcomes of SCLC in never-smokers. Defining SCLC subgroups based on clinical characteristics, specifically smoking status, may lead to treatment advances in this historically recalcitrant cancer.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We performed a multicenter analysis using the Flatiron Health electronic health record-derived database, a nationally representative database comprising patient-level structured and unstructured data curated via technology-enabled abstraction. The cohort consisted of patients with clinician confirmed SCLC diagnosed on or after January 1, 2013. Genomic data from a clinico-genomic database developed by Flatiron and Foundation Medicine was used for a subset of patients that had received next-generation sequencing on the FoundationOne panel. Clinical and genomic characteristics were compared between smokers and never-smokers using descriptive statistics while the presence of other cancers was confirmed via chart review for never-smokers. Association of patient characteristics with overall survival was assessed using a univariate Cox proportional hazards model.

      4c3880bb027f159e801041b1021e88e8 Result

      103 of 4655 (2.2%) SCLC patients were never-smokers. Characteristics of these patients were: female 65%, male 35%; Asian 4.85%, Black 4.85%, White 62.1%; extensive-stage (ES) 68.9%, limited-stage (LS) 20.4%, unknown 10.7%. Compared with smokers (n=4552), never-smokers were more likely to be 80+ years (p=0.040), female (p=0.013), Asian (p<0.001), and present with ES (p=0.038). Based on univariate analyses, poor prognostic factors in never-smokers included sodium < 140 mEql/L (HR=1.95; p=0.028) and ES (HR=2.62; p=0.013). 26 (25%) patients had confirmed history of multiple primary malignancies. Three patients had prior history of organ transplant and two patients had history of pulmonary fibrosis. Survival of never-smokers (8.0 months for ES and 20.6 months for LS) appeared similar to historical data from smokers with SCLC. In the subset of 251 SCLC patients where tumor mutation data was available, never-smokers (n=18, 7.2%) were less likely to have a detectable alteration in TP53 (44.4% vs 95.3%; p<0.001) or RB1 (27.8% vs 76.8%; p<0.001).

      8eea62084ca7e541d918e823422bd82e Conclusion

      The never-smoker subgroup of SCLC patients has important clinical and genomic features that portend diagnostic, prognostic, and therapeutic opportunities. A high-frequency of other malignancies raises concern for neuroendocrine differentiation from other primary tumors. This series represents the largest reported data on SCLC in never-smokers.


      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.