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Deysi Garcia



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    EP1.12 - Small Cell Lung Cancer/NET (ID 202)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Small Cell Lung Cancer/NET
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.12-15 - Oncologic Treatments and Outcomes for Small-Cell Lung Cancer Patients with Brain Metastases (Now Available) (ID 1877)

      08:00 - 18:00  |  Author(s): Deysi Garcia

      • Abstract
      • Slides

      Background

      Brain metastases (BM) are common in patients with small-cell lung cancer (SCLC), and are associated with short survival. Few data are available on this specific population of patients with SCLC and BM, as they are usually excluded from prospective randomized clinical trials.

      Method

      We present data on all patients diagnosed with BM from SCLC from the Cancer Register of the Hospital Universitari Dr. Josep Trueta during 2013–2017. Age, gender, and treatment in patients were recorded. Data cut-off for survival analysis was 28th March 2019.

      Result

      We identified 50 patients with SCLC and BM. Median age: 66 y (range: 4882 y); male: 39 (78%). Synchronous BM were observed at the diagnosis of primary lung cancer in 33 (66%) patients. Impact of treatments on median overall survival (mOS) is summarized in Table 1. Only 1 patient received brain surgery (with an OS of 6.5 months). One-third of patients (34%) received best supportive treatment as unique treatment. The 1-year OS was 18% in our study.

      Table 1
      Treatment %

      mOS

      (without treatment)

      mOS

      (with treatment)
      p-value
      Brain radiotherapy 52 % 1.4 m 9.1 m < 0.000001
      Chemotherapy 50 % 1.5 m 6.9 m =0.003
      Brain radiotherapy and chemotherapy 34 % 1.6 m 10.7 m =0.000331

      Conclusion

      Our real-world data reinforce the need for better therapies to improve the prognosis of patients with SCLC and BM.

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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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      P2.01-49 - Targeting STAT3-Positive Reactive Astrocytes with Silibinin in the Therapeutic Landscape of Non-Small-Cell Lung Cancer with Brain Metastases (Now Available) (ID 1336)

      10:15 - 18:15  |  Author(s): Deysi Garcia

      • Abstract
      • Slides

      Background

      Silibinin is a bioactive flavonolignan extracted from milk thistle (Silybum marianum) and is a direct inhibitor of STAT3 – with high affinity to both the Src homology-2 domain and the DNA-binding domain of STAT3. Pre-clinical data indicate that blocking STAT3 signaling in reactive astrocytes, a major component of the brain metastasis microenvironment, can decrease the number and size of brain metastases (BM).

      Method

      We present data on all patients diagnosed with BM from non-small cell lung cancer (NSCLC) from the Cancer Register of the Hospital Universitari Dr. Josep Trueta during 2013–2017. Age, gender, histology, and treatment in patients were recorded. During this period, some patients received compassionate use of Legasil®, a commercially available silibinin-based nutraceutical, in addition to standard oncologic treatment. The data cut-off for survival analysis was 28th March 2019.

      Result

      We identified 221 patients with NSCLC and BM. Median age: 62 y (range: 3288 y); male: 161 (72.9%). Synchronous BM were observed at the diagnosis of primary lung cancer in 133 (60.2%) patients. Differences in median overall survival (mOS) were detected by histology subtype: adenocarcinoma (66.1%)=4.6 m, squamous (17.6%)=1.8 m, not otherwise specified (16.3%)=2.2 m, p=0.000003. Treatment effects on mOS are summarized in Table 1. In the subgroup of patients that received brain radiotherapy in addition to systemic therapy for BM, differences were maintained between patients that received Legasil® (n=15) or not (n=64):28.5 months vs 6.3 months (p=0.000052).

      Table 1
      Treatment %

      mOS

      (without)

      mOS

      (with treatment)
      p-value
      Brain radiotherapy 53.8% 1.9 m 5.1 m < 0.000001
      Systemic therapy 52% 1.6 m 6.9 m < 0.000001
      Brain surgery 5% 3.2 m 15.5 m =0.000127
      Silibinin supplementation 8.1% 3.5 m 22.8 m =0.000001

      Conclusion

      Our data indicate that silibinin supplementation could contribute to the control of BM in patients with NSCLC. Further evaluation of silibinin, or other STAT3 inhibitors, in clinical trials is warranted in this setting.

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