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Kathrin Gennen



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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 3
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      33P - Prognostic value of CD8-positive tumor stroma-infiltrating lymphocytes and PD-L1 positive tumor cells at initial biopsy in patients with locally advanced NSCLC treated with chemoradiotherapy (ID 581)

      12:30 - 13:00  |  Presenting Author(s): Kathrin Gennen

      • Abstract
      • Slides

      Background

      According to results of PACIFIC trial, immune checkpoint inhibitors (CPIs) are an integral part of the multimodal treatment approach for inoperable locally-advanced non-small cell lung cancer (LA-NSCLC). The purpose of this single-center study was to investigate a prognostic value of CD8-positive tumor stroma-infiltrating lymphocytes (TILs) and PD-L1 positive tumor cells at initial biopsy in patients treated with definitive chemoradiotherapy (CRT).

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      We collected initial tumor tissue samples and reviewed the clinical characteristics of 36 LA-NSCLC patients treated at our center with definitive CRT between 2000 and 2004. The analyzed tumor tissue was taken before start of multimodal treatment. An experienced pathologist performed the immunohistochemistry analysis and interpretation. Tumor cells and CD8-positive tumor stroma-infiltrating lymphocytes were analyzed separately. Based on PD-L1 expression on tumor cells, patients were divided into three subgroups (0%, 1-5%, >5%). Two patient subgroups were defined according to CD8 expression in the tumor-surrounding stroma (low and high density: 0-40% vs. 41-100%).

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Thirty-six patients with LA-NSCLC were treated with definitive CRT (stage II, III and IV: 2, 30 and 4 patients). 18 (50%) patients had squamosa cell carcinoma, 14 patients (39%) adenocarcinoma and 4 patients (11%) NOS. Patients with high density of CD8 positive tumor stroma-infiltrating lymphocytes (TILS) showed a significantly reduced overall survival than patients with low density (13 vs. 19 months, one-year survival 56.5 vs. 69.2% p = 0.047); Patients without (0%) and low expression (1-5%) of PD-L1 on tumor cells showed a significantly improved overall survival compared to patients with a PD-L1 expression on tumor cells over 5% (median survival: 13.8 vs. 6.6 months, 1-year survival rate: 67.7 vs. 33.3%; p = 0.039).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      High density of CD8-positive tumor stroma-infiltrating lymphocytes and PDL1 expression on tumor cells over 5% at initial biopsy correlates significantly with reduced overall survival in patients with LA-NSCLC treated with CRT.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

      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.

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      93P - Heterogeneity score in inoperable stage III non-small cell lung cancer patients treated with definitive chemoradiotherapy: A single centre analysis (ID 563)

      12:30 - 13:00  |  Author(s): Kathrin Gennen

      • Abstract

      Background

      Inoperable stage-III non-small cell lung cancer (NSCLC) represents a very heterogeneous disease in terms of patient and tumor characteristics. A simple heterogeneity score may help to personlize multimodal therapy.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      The data of 99 patients with performance status ECOG 0-1 treated with chemoradiotherapy (CRT) for inoperable stage III NSCLC, treated between 2011 and 2016 at our hospital were analyzed. Patient- and tumor-related factors were evaluated, and factors showing a significant negative association with patient survival were scored with one point each. Three subgroups with a low, intermediate and high-risk (0-1, 2-3 and 4-5 points) score were defined. The results were validated in a prospective cohort of 35 patients.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Concurrent CRT was administered in 78% (n = 78) of patients and sequential CRT in 11% (n = 11), 10 Patients were treated with radiotherapy alone. 53% (n = 53) of patients received induction chemotherapy. Median overall survival (mOS) for the entire cohort was 20.8 months. Age (p = 0.020), gender (p = 0.007), cumulative tobacco pack years (PY) (p = 0.015), tumor-associated atelectasis (p = 0.004) and histology (p = 0.011) had a significant impact on survival in univariate analysis. 12, 59 and 28 patients had low, intermediate and high-risk score. MS, 1-, 2- and 3-year survival rates were as follows: not reached, 100%, 83% and 67% in the low, 22.9 months, 80%, 47% and 24% in the intermediate and 13.7 months, 57%, 25% and 18% in the high-risk score subgroup. Prospective validation of the score demonstrated one-year survival of 100% for patients in the low-risk subgroup, 93% in the intermediate-risk subgroup, and 69% in the high-risk subgroup (p = 0.100).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      This simple heterogeneity score was developed for inoperable stage III NSCLC patients with good performance status receiving multimodal therapy. The score may aid physicians to infer clinical outcomes and optimize decisions concerning treatment strategies, as well as planning of prospective studies.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

    • +

      95P - The role of patient performance status and its changes before and after completion of multimodal treatment for inoperable stage III NSCLC (ID 584)

      12:30 - 13:00  |  Author(s): Kathrin Gennen

      • Abstract
      • Slides

      Background

      The Eastern Cooperative Oncology Group performance score (ECOG-PS) is used in clinical routine to quantify patients’ general condition. We evaluated ECOG-PS before, after and its changes in the course of chemoradiotherapy (CRT) in patients with inoperable stage III NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      The data of ninety-nine patients with NSCLC UICC stage IIIA/B (TNM 7th edition) were evaluated. ECOG-PS before treatment, at first follow-up and the difference was examined for their impact on overall survival (OS) from initial diagnosis and event-free survival (EFS) from the first day of radiation.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Median survival for the entire cohort was 20.8 (range: 15.3-26.2) months. Before the start of multimodal treatment, ECOG-PS was 0 in 48% and 1 in 52% of patients; median OS, 1- and 2-year survival rates were 26.4 months, 85% and 53% for ECOG-PS 0 and 18.9 months, 69% and 37% for ECOG-PS 1 patients (p = 0.1). After completion of CRT 65% of patients had the same or better and 35% worse ECOG-PS: 0 in 34%, 1 in 46%, 2 in 18% and 3 in 2% of patients. Median OS, 1- and 2-year survival rates were 40.3 months, 88% and 64% for ECOG-PS 0; 19.3 months, 82% and 40% for ECOG-PS 1; 11.9 months, 50% and 28% for ECOG-PS 2 and 7.6 months, 0% and 0% for ECOG-PS 3 (p < 0.001). Deterioration of ECOG-PS after multimodal treatment significantly impaired survival in the initial ECOG-PS 0 (p = 0.005, median 19.1 vs 31.4 months) and 1 (p = 0.001, median 22.9 vs 11.1 months) subgroups. Median EFS was 9.6, 9.0, 7.9 and 3.5 months for patients with ECOG-PS 0, 1, 2, 3 after completion of CRT (p = 0.018). EFS was not affected by initial ECOG-PS but was significantly impaired by deterioration of ECOG-PS after completion of multimodal therapy with a median time of 9.4 vs 7.7 months (p = 0.049), respectively.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Deterioration of ECOG-PS after completion of primary multimodal treatment is a significant negative prognostic factor.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

      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.