Virtual Library
Start Your Search
Enrica Capelletto
Author of
-
+
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
-
+
P2.01-74 - Clinical-Pathological Features and Outcome of Patients with Oral Metastases from Lung Cancer: A Multicenter Retrospective Study (ID 2701)
10:15 - 18:15 | Author(s): Enrica Capelletto
- Abstract
Background
Oral metastases are a rare event, accounting to less than 1% of all oral malignancies, sometimes being the first manifestation of a wide-spread disease. Regardless of the site of the primary tumor, patients with oral metastases have a poor prognosis, with a reported median overall survival (mOS) of 6 months. Lung cancer, particularly small cell lung cancer (SCLC) and poorly differentiated carcinoma, represents the main source of oral metastases, even if large datasets still lack. We conducted a multicenter retrospective study investigating incidence, clinical-pathological features and outcome of patients with oral metastases from lung cancer.
Method
Between January 2014 and December 2018 we collected data from all consecutive patients diagnosed with lung cancer in four oncological Italian centers. Clinical-pathological features of those patients with oral metastases involving jaw or/and soft tissues were described.
Result
Among 4,082 consecutive lung cancer patients, the incidence of oral cavity metastases was 0.15% (6 out of 4,082 patients,). Patients were more frequently male (5 out of 6, 83%), current or former smokers (5 out of 6, 83%), with a median age at diagnosis of 61 years (range 53-69) [table 1]. Four different histotypes of lung cancer were detected. Five patients (83%) were stage IV ab initio, with synchronous histologically confirmed oral metastases. All these patients had distant metastases other than in the oral cavity (median of 5 different metastatic sites). The mOS since the diagnosis of oral metastases was 67 days (range 36-166).
Table 1. Patient characteristics
Gender
Age (years)
Smoke
Histotype
N° metastatic sites
Site of oral lesion
Time between stage IV diagnosis and oral lesion occurrence
Local radiotherapy
Median OS from oral lesion occurrence (days)
M
69
Current
Poorly differentiated
4
Jaw
Syncronous
Yes
57
M
61
Current
Sarcomatoid
5
Jaw
Syncronous
Yes
107
M
61
Former
Adenocarcinoma
3
Gum
11 months
Yes
77
M
53
Former
Poorly differentiated
4
Gum
Syncronous
No
44
M
59
Current
SCLC
5
Gum
Syncronous
No
36
F
66
Unknown
Squamous (mut ex 19 EGFR)
5
Gum
Syncronous
No
166
Conclusion
To our knowledge, this is the largest study assessing the incidence of oral metastases in lung cancer patients. Oral involvement, usually diagnosed at an advanced stage, seems to be associated with a very poor prognosis, with a mOS of about 2 months. Further confirmatory datasets are warranted.
-
+
P2.04 - Immuno-oncology (ID 167)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
-
+
P2.04-84 - NSCLC Survival Expectancy for Patients Treated with Docetaxel/Nintedanib in the SENECA Trial and Previous Immunotherapy (ID 807)
10:15 - 18:15 | Presenting Author(s): Enrica Capelletto
- Abstract
Background
The phase IIb SENECA trial was an Italian real-world experience recently ended, which demonstrated similar progression free survival (PFS) and overall survival (OS) in non-squamous non-small cell lung cancer (nsNSCLC) patients treated with second-line docetaxel/nintedanib, regardless the relapsing-time from end of first-line chemotherapy and the docetaxel schedule employed (weekly or q3wks), with a slightly higher toxicity-trend in the q3wks arm. During accrual period (January 2016-April 2018), no therapeutic alternative to the use of docetaxel was available for patients with recurrent nsNSCLC until April 2017, when the first immune-checkpoint inhibitor was approved and reimbursed in Italy in this setting. At that point, the study was amended allowing enrolment of patients previously treated with immunotherapy (IT). Because of the lack of data about the optimal therapeutic algorithm in this context, aim of the present evaluation is to investigate if survival expectancy of patients treated with docetaxel/nintedanib could positively influenced when previously treated with IT.
Method
In the SENECA trial, 212 nsNSCLC patients, progressing after first-line chemotherapy, were treated with docetaxel plus continuous oral nintedanib, with the possibility of maintenance in case of stabilization or response. This evaluation focus on 16 patients previously treated with IT and compares them to the rest of patient population. Survival analysis is performed using Kaplan Meier curves; Hazard Ratios (HR) with 95% Confidence Interval (95%CI) are reported to compare the two groups.
Result
Patients treated with IT (2 combined with first-line chemotherapy, 14 alone) correspond to 7.5% of the entire study population; they were 9 males and 7 females, with a median age of 62.5 years, mainly current or former-smokers, with an ECOG-performance status 0 in 93.7% of cases. At the cut-off date (December 25th, 2018), after a median follow-up of 35.5 months, no significant differences appear between patients previously treated with IT and the other ones in terms of PFS (5.84 vs 4.31 months, respectively; HR 0.564 [95% CI 0.283-1.122], p-value=0.1029), and OS (9.37 vs 9.02 months, respectively; HR 1.108 [95% CI 0.393-3.123], p-value=0.8456). No significant differences have been observed also in disease-control rates (80.0% vs 66.7%, p-value=0.5436).
Conclusion
Despite this report does not show a greater survival expectancy for patients treated with docetaxel/nintedanib and previous IT, it's likely that the small sample size may affect this result. The longer PFS and greater disease-control rate are attractive hints for future evaluations with larger sample sizes, supposing a new therapeutic algorithm for recurrent nsNSCLC patients.
