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Vasiliki Nikolaidou



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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
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.01-84 - Second Line Treatment with Docetaxel/Nintedanib in Patients with Metastatic Non Small Cell Lung Adenocarcinoma-Preliminary Results (Now Available) (ID 2302)

      08:00 - 18:00  |  Author(s): Vasiliki Nikolaidou

      • Abstract
      • Slides

      Background

      The treatment landscape of non small cell lung cancer (NSCLC) has changed dramatically during the last years involving targeted therapy, chemotherapy ± immunotherapy or/and antiangiogenic agents, based mainly on patients’ molecular characteristics. Not all patients respond well to immunotherapy, so there is an essential need for other effective treatments.

      Method

      The aim of this prospective study is to estimate and record, the efficacy of the combination of Docetaxel with Nintedanib as a second line therapy in metastatic NSCLC. There were 20 patients, 16(80%) men, 4(20%) women, median age 62(52-73) years and median ECOG 1(0-3), without driver mutations, consecutively admitted in Evangelismos Oncology Department in Athens, Greece from 27/11/2017- 23/02/2019.

      Result

      All patients had received Cisplatin/Pemetrexed/Bevacizumab as first line treatment for their disease, with a median duration of 104(45-255) days. Progressive disease sites were found in lung, liver, and bones in :18/20(90%), 8/20(40%) and 4/20(20%) patients respectively. All received as second line treatment Docetaxel 75mg/m2 q3weeks plus Nintedanib 400mg p.o., d 2-20 in 21 days cycles. CEA, CA125, NSE, CA19.9, CA72-4 and Cyfra 21.1 tumor markers were monitored according to our clinical protocol. Increased values of these markers were documented at initiation of therapy in 18, 14, 10, 14 ,0, 2 patients respectively.

      After 3 cycles of treatment all patients were reevaluated and in 2 of them partial response (P.R.) was documented, with 40-50% reduction of CEA, CA125, CA19.9 και Cyfra 21.1, while 12 patients had stable disease (S.D.) with no more than 20% change in the aforementioned tumor markers. Six patients with progressive disease (P.D.) showed significant increase of CEA, CA 125, NSE, CA 19.9 and CA 72-4. The responders (P.R.+ S.D.) continued therapy for a median of 5(3-8) cycles.

      Among 96 cycles of chemotherapy, any toxicity grade ≥ ΙΙ occurred in 14 (7%) of them. Anaemia in 7(50%), stomatitis in 4(28.5%), diarrhea in 5(36%) and AST/ALT elevation of >2.5 fold in 3(21%) cycles respectively. All patients were treated symptomatically, without dose reduction in any patients

      Conclusion

      The combination of Docetaxel/Nintedanib in metastatic NSCLC adenocarcinoma, following progressive disease post Cisplatin/ Pemetrexed/ Bevacizumab treatment, showed 70% response rate. Although the number of the patients included in the study is small, we concluded that the tumor markers examined, had a clear correlation with the disease outcome. No major toxicity issues were documented. Larger studies are needed in order to make more solid conclusions.

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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
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.01-61 - Multiple Primary Carcinomas (MPC) in Patients with Non Small Cell Lung Cancer (NSCLC) (ID 914)

      10:15 - 18:15  |  Author(s): Vasiliki Nikolaidou

      • Abstract
      • Slides

      Background

      The improving survival of NSCLC patients, due to: 1. the initial diagnosis in early stages using the newer modern diagnostic tools, 2. the treatment of the disease with new effective antineoplastic drugs, and 3. the remarkable suspicion of the physicians, leads to registry of high incidence ratio of MPC in NSCLC patients.

      Method

      The aim of the study was the registration of the number and clinical characteristics of MPC in NSCLC patients. Between 4/1986-3/2019, 1756 patients, 1123 (64%)men, 633 (36%)women, median age 64(33-87)years and ECOG 2(0-3) were consequently admitted in our Unit. Stage <IIIA had 304(17%) and ≥IIIA 1452(83%)patients (groups A, B respectively). Median follow-up was 20+(1+-240+)months. Survival ≥5years observed in 351(20%)patients. According to our protocols, patients stage <IIIA, underwent only follow-up after radical surgery, while patients stage IIIA treated with platinum-based chemotherapy(PBC) adjuvantly or neoadjuvantly±locoregionally radiotherapy. Patients stage ≥IIIB received therapeutically PBC±radiotherapy.

      Result

      Eighty-six patients, 78/1123(7%)men, 8/633(1%)women (p<0.001), developed 102 MPC. The median interval time between NSCLC diagnosis and MPC detection, was 58(0-220)months. Two men experienced by four (all metachronous)MPC. One with lung adenocarcinoma(LADC), developed non-AIDS Kaposi-sarcoma of the leg, MDS and squamous-cell lung cancer(SqCLC). The second, with LADC, developed transitional-cell bladder carcinoma(TCBC), prostate adenocarcinoma(PrC), and colon cancer(CC). Five patients(3 men, 2 women) had by three, metachronous, MPC. One had LADC, NHL, CC, the second LADC, TCBC, PrC, and the third SqCLC, CLL and CC. One woman experienced LADC, lymphopenic HL and breast cancer(BC) and the other LADC, CLL, and small-cell lung carcinoma. Other 79 patients developed 79 MPC, 11(14%)median age 63(51-77)years, synchronous and 68(86%)median age 63.5(34-75)years, metachronous The synchronous were LADC/SqCLC in 2, LADC/PrC in 2, LADC/TCBC in 2, SqCLC/head-neck squamous-cell carcinoma(HNSqCC) in 2, and SqCLC/CC in 3 cases. The metachronous MPC were LADC, CLL, TCBC, SqCLC, PrC, CC, HNSqCC, BC, NHL, HL, in 12, 10, 8, 8, 8, 8, 6, 3, 3, 2, cases respectively. Among 351 patients surviving ≥5years, 40(11%) experienced MPC versus 46/1405(3%) with survival <5years(p <0.001). Seventy-five patients diagnosed with metachronous MPC: 10/304(3%) versus 65/1452(4.5%) of group A and B, (p=NS). There was no statistically significance in the location of non-haematological MPC related to the diaphragm (37 upper, 39 lower the diaphragm).

      Conclusion

      According to our findings in NSCLC patients: 1. MPC detection is not uncommon, mainly in men. 2. The longer survival enhances the possibility of MPC. This must be considered during the follow-up of those patients. 3. Previous chemoradiotherapy doesn’t increase the risk of MPC.

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