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Jacek Jassem
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ES20 - Strategies for Cancer Patients to Have Optimal Outcomes (ID 23)
- Event: WCLC 2019
- Type: Educational Session
- Track: Prevention and Tobacco Control
- Presentations: 1
- Now Available
- Moderators:Yuko Nakayama, Michael Menefee
- Coordinates: 9/09/2019, 14:00 - 15:30, Colorado Springs (1994)
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ES20.01 - Tobacco Cessation After Cancer Diagnosis: Declaration from IASLC (Now Available) (ID 3267)
14:00 - 15:30 | Presenting Author(s): Jacek Jassem
- Abstract
- Presentation
Abstract
Tobacco Cessation After Cancer Diagnosis: Declaration from IASLC
Tobacco use is a well established cause of cancer, contributing to about 1 in 3 cancer deaths annually. Whereas detrimental effects of smoking are well recognized, the harms of continued smoking after a cancer diagnosis are undervalued (1). Smoking by cancer patients and survivors causes adverse treatment outcomes, including increased overall mortality, cancer related mortality and risk for second primary cancer, and considerably increases cancer treatment toxicity (2,3). The clinical effects of smoking after a cancer diagnosis has a substantial effect on increased cancer treatment costs (4). Smoking cessation after a cancer diagnosis can improve cancer treatment outcomes (1), but most cancer patients who smoke at the time of diagnosis persist in a smoking habit during long term follow-up (5). Unfortunately, oncologists often do not work with their patients to quit, and do not provide tobacco cessation assistance for continuing tobacco users (6,7). Large analyses of IASLC members demonstrate that although most oncologists recognize that smoking causes adverse outcomes, approximately 90% ask about tobacco use and 80% advise patients to quit, only few offer assistance with quitting (8). There is a clear and unmet need to address tobacco use in patients with cancer. The diagnosis of cancer is “the teachable moment”, allowing health care professionals the best opportunity to discuss with patients their lifestyle habits, including nicotine addiction (9). An enhanced focus on smoking cessation at the time of a cancer diagnosis and its active promotion may increase patients’ motivation to quit. All patients should be screened for tobacco use and advised on the benefits of tobacco cessation. In patients who continue smoking after diagnosis of cancer evidence-based tobacco cessation assistance should be routinely and integrally incorporated into multidisciplinary cancer care. Smoking status should be a required data element for all prospective clinical studies, and clinical trials of patients with cancer should be designed to determine the most effective tobacco cessation interventions (10). Recognizing the critical importance of smoking cessation to increase the efficacy of cancer treatment, these postulates will be a subject of IASLC Declaration presented at the 20th World Conference On Lung Cancer in Barcelona.
References:
1. Warren GW, Simmons VN. Tobacco Use and the Cancer Patient. In: Lawrence TL. editor. DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology, 11th ed. Philadelphia, PA: Lippincott, Williams, & Wilkins, 2018.
2. National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, 2014.
3. Jassem J. Tobacco smoking after diagnosis of cancer: clinical aspects. Transl Lung Cancer Res 2019. doi: 10.21037/tlcr.2019.04.01
4. Warren GW, Cartmell KB, Garrett-Mayer E, et al. Attributable failure of first-line cancer treatment and incremental costs associated with smoking by patients with cancer. JAMA Netw Open 2019;2:e191703.
5. Westmaas JL, Newton CC, Stevens VL, et al. Does a recent cancer diagnosis predict smoking cessation? An analysis from a large prospective US cohort. J Clin Oncol. 2015;33:1647-52.
6. Burke L, Miller LA, Saad A, et al. Smoking behaviors among cancer survivors: an observational clinical study. J Oncol Pract 2009; 5: 6-9.
7. Warren GW, Marshall JR, Cummings KM, et al. Addressing tobacco use in patients with cancer: a survey of American Society of Clinical Oncology members. J Oncol Pract 2013; 9: 258-62.
8. Warren GW, Marshall JR, Cummings KM, et al. Practice patterns and perceptions of thoracic oncology providers on tobacco use and cessation in cancer patients. J Thorac Oncol. 2013;8:543-8.
9. Gritz ER, Fingeret MC, Vidrine DJ et al. Successes and failures of the teachable moment: smoking cessation in cancer patients. Cancer. 2006 Jan 1;106:17-27.
10. Toll BA, Brandon TH, Gritz ER, et al. Assessing tobacco use by cancer patients and facilitating cessation: An American Association for Cancer Research Policy Statement. Clin Cancer Res 2013; 19: 1941-8.
Only 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, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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P2.01 - Advanced NSCLC (ID 159)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.01-66 - Genomic Landscapes of DNA Copy Number Alterations in Primary Lung Cancers and Matched Brain Metastases (Now Available) (ID 1726)
10:15 - 18:15 | Author(s): Jacek Jassem
- Abstract
Background
Lung cancer (LC) is the leading cause of cancer mortality worldwide. The majority of LC patients will develop distant metastases at some point during their disease, and brain is among the most common sites of relapse. However, little is known about the mutational landscape of brain metastases (BM) and their potential inter-tumor heterogeneity. Better knowledge on this subject may pave the way to new therapeutic strategies. Here, we map the DNA copy number alterations (CNAs) by sequencing a cohort of primary LC samples and matched BM.
Method
The study group included 57 patients (21 females and 36 males, median age 61±8 years; 35 adenocarcinomas, 18 squamous-cell carcinomas, 2 large-cell carcinomas, 1 adenosquamous carcinoma and 1 small-cell lung cancer). From all patients pair-matched tissue samples from primary tumor and corresponding BM were collected, fixed in formalin and embedded in paraffin. All patients were therapy-naïve at the time of primary tumor collection. Genomic DNA was extracted using the QIAamp DNA FFPE Tissue Kit (Qiagen, Germany), followed by NGS library preparation using the NEBNext Ultra II DNA kit (NEB, USA). Samples were sequenced shallowly (average depth 26 Mreads) on the NextSeq 500 system (Illumina, USA). The R package QDNAseq was used to call and visualize DNA copy number levels. The P value of <0.05 (Wilcoxon paired test) was considered statistically significant.
Result
The median time between primary LC diagnosis and BM occurrence was 13 months range, 0 to 91 months), and synchronous BM were diagnosed in 12% of patients. Overall survival in the entire group was 22.5 months. The number of CNA was significantly higher in BM than in primary tumor, regardless of clinical/demographic data or type of aneuploidy (gains/losses). Primary tumors harbored significantly more gains and almost no losses. In both tumor sites, the most frequent gains affected 1q, 5p, 7p, 8q and 20q, whereas gains of 17q and 19q, and losses of 4p, 4q, 5q, 8p, 9p, 16q, 17p, 18q, 22q were identified only in BM. The fraction of the genome affected by mutational events in BM correlated positively with time to BM development. Three the top altered genes (IL7R, MLT11, SETDB1) were identical in both primary lesions and BM.
Conclusion
Our results indicate that while primary LC lesions harbor frequent amplifications, the CNA landscape of BM is dominated by deletion events. Higher number of CNA harbored by late compared to synchronous BM suggests high levels of genomic instability.
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PR01 - Press Conference (ID 92)
- Event: WCLC 2019
- Type: Press Conference
- Track:
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/07/2019, 16:00 - 17:30, CC7.1 A&B
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PR01.06 - IASLC Tobacco Declaration (Now Available) (ID 3604)
16:00 - 17:30 | Presenting Author(s): Jacek Jassem
- Abstract
- Presentation
Abstract not provided
Only 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, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
