Author of

• 28971

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  Lunch & Poster Display session (ID 58)

  • Event: ELCC 2019
  • Type: Poster Display session
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1

  • 29138

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    207P - Primary mucinous carcinomas of the lung: Clinical characteristics and treatment outcomes (ID 340)

    12:30 - 13:00  |  Author(s): L K Rajeev
    • Abstract

    Background
    

    Invasive mucinous carcinoma (IMA) is a distinct histopathologic variant of adenocarcinomas of lung comprising about 2 – 10%. A large proportion of IMAs carry KRAS mutations and only rarely EGFR mutations or ALK/ROS translocations, thus most cases are not amenable for targeted therapy at present. This study was conducted to elicit the unique clinico-pathological characteristics of IMA.

    a9ded1e5ce5d75814730bb4caaf49419 Methods
    

    Medical records of patients diagnosed with IMA by needle biopsy at Kidwai Cancer Institute, Bangalore from 2013 to 2018 were retrieved, clinical presentations and treatment outcomes were reviewed. Statistical analysis was performed using SPSS version 23.0.

    20c51b5f4e9aeb5334c90ff072e6f928 Results
    

    490 cases of needle biopsy of lung were done at our institute between 2013 and 2018. Nine cases (1.8%) were diagnosed as IMA. The median age was 59 years (range 49 – 76 years). The male female ratio was 2:1. Six (66.7%) were current smokers with pack year greater than 20. The median symptom duration before diagnosis was 3 months. Three (33.3%) of the cases were initially misdiagnosed as pneumonia in view of CT findings of pneumonia-like multifocal consolidative appearance. Lung was the most common site of metastasis (77.8%). Serum CEA was elevated in six cases (66.7%). None of the cases had any mutations in EGFR gene or ALK and ROS1 translocations. All cases were treated with Pemetrexed-Carboplatin followed by Pemetrexed maintenance till progression. 5 (55.6%) patients had stable disease, 3 (33.3%) had partial response and 1 (11.1%) had progressive disease after three months of therapy. Median PFS was 12 months (Range 3 – 18 months). Docetaxel was given as second line chemotherapy in all progressed patients. Best response noted was stable disease; seen in 4 (57.1%) cases. Median PFS with docetaxel was 6 months (range 3- 8 months). Median overall survival 16 months (range 9 - 27 months). Patients with progressive disease had serial rise in Serum CEA.

    fd69c5cf902969e6fb71d043085ddee6 Conclusions
    

    IMA is rarely diagnosed on needle biopsies due to insufficient tissue for characterisation. They mimic pneumonia on imaging thus delaying diagnosis. EGFR mutations, ALK and ROS1 translocations are usually negative. Response to chemotherapy is modest. Serum CEA may be used as a tumor marker for response assessment.

    b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
    

    Kidwai Cancer Institute.

    213f68309caaa4ccc14d5f99789640ad Funding
    

    Has not received any funding.

    682889d0a1d3b50267a69346a750433d Disclosure
    

    All authors have declared no conflicts of interest.

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