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Sofia España
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EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.01-37 - Platinum-Based Chemotherapy (CT) Rechallenge in Advanced Non Small Cell Lung Cancer (NSCLC) Patients (p): A Single Institution Experience (ID 2689)
08:00 - 18:00 | Author(s): Sofia España
- Abstract
Background
No phase III trials have been carried out to prove the value of a platinum-doublet rechallenge in p with NSCLC. Currently, the availability of different effective drugs makes the platinum-based salvage therapy unusual. Moreover, the potential cumulative toxicity related to cisplatin or carboplatin can be an issue. However, retreatment with platinum-based CT could be hypothetically proposed for p with a long time to progression (TTP) from the last platinum treatment, in p with a good performance status, who may be symptomatic and with no formal contraindication to receive such treatment We have retrospectively reviewed experience at our institution of platinum-based chemotherapy rechallenge in stage III and IV NSCLC p
Method
A cohort of 376 p with stage III and IV NSCLC treated with first-line platinum doublets from January 2012 to December 2017 were included. We extracted information on clinical and molecular characteristics, as well as treatment details. Time to progression was evaluated by Kaplan-Meier curves and groups were compared using Log-rank test.
Result
Overall, 57 p were rechallenged with platinum-based CT (group A). Median age was 57 years (51.5-65) for rechallenged p versus (vs) 62 (56.2-68.8) for the entire cohort (group B)[p=0.001]. Group A include more p with stage III p( 54.4% vs. 30.7%; p=0.001), as well as more p with better ECOG Performance Status (PS) (PS 0 70.2% vs. 44.5%; p=0.001). No differences in gender, smoking status, histology and comorbidities were observed between both groups (20.7% and 29.8% were women and 38.6% and 53.9% were smokers in groups A and B, respectively).
No differences in molecular profile (EGFR, ALK, ROS1, KRAS, BRAF) were observed. The most common platinum doublet administered in first line setting was cisplatin plus pemetrexed. Group A received more frequently carboplatin plus gemcitabine or vinorelbine. Disease Control Rate (DCR) was 57.9% in p included in group A. No differences in DCR were observed in first line between both groups. Time to progression or death was 9.6 m for gropuo B(5-18.1) vs 20.5 m (14.6-37.3) p <0,001 for p in group A.
Conclusion
Rechallenge with platinum-based CT doublets could represent an option for NSCLC p with good PS and no contraindications for such therapy.
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EP1.04 - Immuno-oncology (ID 194)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.04-25 - Increased PD-L1 Expression in MET Amplified (AMP) Advanced Non Small Cell Lung Cancer (NSCLC) Patients (P) (ID 2764)
08:00 - 18:00 | Author(s): Sofia España
- Abstract
Background
MET amp has been reported in a subset of NSCLC p and treatment with crizotinib has proved clinical activity in cases of MET exon 14 alterations and MET amp.. Recently, immunotherapy has emerged as a new approach to treat NSCLC. The development and success of programmed cell death 1 (PD-1)/program death-ligand 1 (PD-L1) checkpoint inhibitors has been correlated with PD-L1 status, particularly in NSCLC p whose tumors express high PD-L1 levels by tumor proportion score (TPS) ⩾ 50%. In this study we have reviewed the PD-L1 status in a cohort of advanced NSCLC p with a METamp.
Method
PDL1 expression has been evaluated in a retrospective cohort of NSCLC p with MET amp and wild type for EGFR, KRAS, BRAF mutations and ALK and ROS1 rearrangements. Overall Survival (OS) was evaluated with Kaplan-Meier curves and groups were compared using log-rank test. Clinical and tumor characteristics, as well as treatment details, were evaluated. MET amp was analyzed by FISH, while PD-L1 status was assessed by immunochemistry by SP 263. antiboby
Result
A total of 50 p were included, 15 p has high or intermediate Met amp and 35 p had low or negative Met amp. Median age were 66 years old. 39 (78%) p were male, 43 (86%) p were smokers or former smokers, 37 p (74%) were ECOG PS 0-1, 37 p (74%) were stage IV. PD-L1 were negative ( < 1%) in 21 p (42%), positive ( >1%) in 26 p ( 52%). PD-L1 highly positive in 18 p ( 36%). Statistically significant more p had PD-L1 positive ( TPS > 1%) in high or intermediate Met amp p versus low or negative ( 92.9% vs 39.4%; p 0.001). And high or intermediate Met amp p had PD-L1 high expression ( TPS > 50%) than negative or low Met amp p ( 64.3% vs 27.3%; p 0.020). No differences in PD-L1 expression was observed by gender, ECOG PS or smoking status. Median OS was 16.367 m (2.295-30.438). No differences in OS were seen by PD-L1 expression or Met amp status.
Conclusion
PD-L1 expression in NSCLC p is positively correlated with MET amp, especially in p with PD-L1 > 50%. Our data suggests that MET amp may play a direct role in up-regulating PD-L1 expression in NSCLC p. Additionally, combination therapy targeting MET and checkpoint inhibition should be considered as a potential therapeutic strategy for NSCLC p with high and intemediate MET amp.
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P1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 186)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.16-44 - Multiple Primary Cancers (MPC) in a Cohort of Lung Cancer (LC) Patients (P): Incidence and Clinical Features (ID 2236)
09:45 - 18:00 | Author(s): Sofia España
- Abstract
Background
The prognosis of p with LC has drastically changed during the last decade due to the improvement in prevention, diagnosis and treatment. Therefore, the number of LC survivor ps has significantly increased and subsequently the incidence of MPC is also rising. This study investigates the co-occurrence of MPC among p diagnosed with LC.
Method
We reviewed of clinical data of patients with histologically confirmed LC visited at our institution between February 2016 and December 2018.
Result
A total of 492 p out of 777 p, (63.3%) had adenocarcinoma and 223 p (28.7%) had squamous LC. The most frequently related comorbidities were hypertension (42.5%), dyslipidemia (36.2%), COPD (21%), cardiovascular disease (15.7%) and diabetes mellitus (14.5%). Molecular analysis was perform in 402 p (51.7%). EGFR mutation was detected in 77 p (exon 19 in 14% and exon 21 in 5% of p). ALK and ROS1 translocation were diagnosed in 27 and 7 p, respectively.
Two primary cancers occurred in 111 cases (14%), including 15 p (1.9%) with three or more primary cancers. Patients with MPC were predominantly males (76.8%), smokers (85%) and 34% had prior family history of MPC. Median age at the first tumor diagnosis was 64 years (57-71). LC occurred as first neoplasm in 8.1% of the cases, 92 p (83%) developed metachronic MPC and 19 p (17%) synchronous MPC. Most common secondary primary cancer were head and neck in 19%, non-melanoma skin cancer in 19%, prostate in 12.6%, bladder and upper urinary tract cancer in 10%, colorectal in 6.3% and breast in 5.4%.
First-line treatment for advanced or locally advance LC included chemotherapy in 65.6%, concomitant chemoradiotherapy in 14%, targeted therapy in 4% and immunotherapy in 4%. Overall response rate (ORR) to first-line treatment was 43.7%. Second-line treatment included chemotherapy in 47.6% and immunotherapy in 30.4%, with and ORR of 30%.
Conclusion
In our series, the frequency of the co-occurrence of MPC among LC p is 14%, suggesting that surveillance strategies are recommended in this population. Most frequent MPC in LC patients are related to smoking. ORR in first and second-line are consistent with the literature.
