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Abed Agbarya



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    EP1.11 - Screening and Early Detection (ID 201)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Screening and Early Detection
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.11-21 - Lung Cancer Screening Pilot in Israel (Now Available) (ID 2278)

      08:00 - 18:00  |  Author(s): Abed Agbarya

      • Abstract
      • Slides

      Background

      Lung cancer kills more people than any other cancer, both in Israel and worldwide. In israel 2000 die from the disease each year where the prevalence of smoking is 22.5% above age 21. There is not yet a national lung cancer screening program in Israel, therefore the Israeli Lung Cancer foundation (ILCF) initiated and funded in cooperation with Assuta Medical centers, a pilot program, ILCF-A, calling participants at risk to come and get checked. The activity took place during the international Lung Cancer awareness month, November 2018.

      Method

      A call for free lung cancer screening was published and promoted on Facebook. People who enlisted filled a questionnaire to evaluate eligibility for screening, which was age 55–74 years, 30 pack-year of smoking history and current smokers or ones who quited within 15 years. There was only a screening arm and LDCT was performed for all subjects. CT reporting and management was performed using LUNGRADS.

      Result

      Overall 90 subjects were eligible and underwent screening of which, 45% were women and 55% men. The average age of subjects was 63 and the average pack years was 45. Most of the subjects were current smokers. In one third of the subjects, nodules were not detected., when detected, average size of nodules was 3.25 mm. Of all subjects, eight were classified with positive results. Four with LUNGRAD score of 3 are under LDCT follow-up. Of the four who had LUNGRAD score of 4, One subject was diagnosed with stage 1 Lung Cancer and had a successful surgery, two subjects were found to be healthy by PET-CT and Bronchoscopy and 1 is still under investigation. Lung Cancer detection rate was 1.11% and FP rate was 7.7%.

      Conclusion

      The ILCF-A trial provided evidence that Lung Cancer Screening in Israel is beneficial. In addition, raising awareness and calling the public to come get screened via digital media has an impact. Despite the limitation of this small study, results of cancer detection rate and FP rates were comparable with NLST and NELSON trials. Although the smoking rate of women in Israel is more then half then that of men (12% compared with 27%), their responsiveness for undergoing screening was as high. Based on this promising evidence, Lung Cancer National Screening program in Israel is recommended and feasible.

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    OA11 - Decomplexifying Molecular Targets, Immunotherapy and Treatment Settings in the Real World (ID 137)

    • Event: WCLC 2019
    • Type: Oral Session
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Now Available
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      OA11.06 - Alternative Nivolumab (N) Duration and Scheduling in Advanced Non-Small Cell Lung Cancer (aNSCLC): Real-Life Data (Now Available) (ID 1921)

      14:00 - 15:30  |  Author(s): Abed Agbarya

      • Abstract
      • Presentation
      • Slides

      Background

      Little is known regarding the optimal scheduling and treatment (Tx) duration of N in aNSCLC. Stopping N after 1 year of Tx negatively affects outcomes.

      Method

      45 consecutive aNSCLC patients (pts) receiving N for ≥2 years (y) were identified in the electronic databases of 4 Israeli cancer centers. These were divided into Groups A (N continued for >2y at a dose 3mg/kg q2w/240mg q2w; n-21), B (N continued for >2y at a dose 3mg/kg q3w-q8w/480mg q4w; n-17), and C (N stopped at 2y for reason other than progressive disease or intolerable toxicity; n-7). PFS (RECIST 1.1) and safety since 2y after N initiation were assessed.

      Result

      Baseline, treatment characteristics and outcomes are presented in the Table and the Picture. Allocation to Group B and C was associated with HR for PFS-2.4 (95%CI, 0.3-18.8, p-0.4) and HR for PFS-3.3 (95%CI, 0.3-30.9, p-0.3), respectively. After 2y since N initiation, new N-related toxicity developed in 24%, 18%, and 28% of pts in Groups A, B, and C, respectively (p-NS).

      table wclc.jpgpicture wclc.jpg

      Conclusion

      A trend for worse outcomes was observed with alternative N scheduling/N quitting 2y after initiation. So far, continuing N at a standard dose until disease progression/ intolerable toxicity remains the standard treatment option.

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