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Jose Alfredo Castellanos



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    P2.10 - Prevention and Tobacco Control (ID 176)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Prevention and Tobacco Control
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.10-09 - Environmental Pollution in the City of Mexico as a Risk Factor for Lung Cancer and Its Prognostic Impact (ID 2834)

      10:15 - 18:15  |  Author(s): Jose Alfredo Castellanos

      • Abstract
      • Slides

      Background

      Lung cancer is the leading cancer in incidence and mortality worldwide. Smoking is the main risk factor, however, in Mexico up to 40% of the population has no history of smoking and its development has been associated with other risk factors such as chronic exposure to wood smoke and environmental pollution. Mexico City and the Metropolitan Area of ​​the State of Mexico have high levels of environmental pollution. In this work, we analyze the prognostic impact of environmental pollution in lung cancer among patients diagnosed with lung cancer who live in those highly polluted areas.

      Method

      We retrospectively analyzed patients diagnosed with non-small cell lung cancer (NSCLC) treated at the National Institute of Cancer, who lived in Mexico City or in the State of Mexico within 10 years before diagnosis of NSCLC. We correlated pollution indexes according with the Atmospheric Monitoring System of the Goverment of Mexico City (http://www.aire.cdmx.gob.mx/default.php?opc=%27YqBhnmU=%27), with the coordinates of their home (Google Maps / Earth R Studio program) to analyze the intensity of contamination with survival. In addition, we correlated the contamination indexes with the degree of differentiation, molecular profile, gender and with the stage at the time of diagnosis.

      Result

      We analyzed the information of 422 patients diagnosed with NSCLC treated in the period between 2011 and 2018. The median age was 62.4 years (SD ± 12.5), 56.6% were women, 41.5% were non-smokers. At the time of diagnosis, 80% were stage IV and 15% stage III. The histology was adenocarcinoma (83%), squamous (10.4%) and small cells (4%). EGFR mutation was detected in 26.5% of the patients and PD-L1 was positive in 2.6% (analyzed 128/422, clone SP263). At the time of this analysis, 43% of the patients had died. The risk of death was higher among patients with the combination of smoking and living in highly polluted areas (RR 9.3), followed those living in highly polluted rates (RR 6.1). Patients living in highly polluted areas showed an increased incidence of poorly differentiated tumors than those who lived in different areas (72% vs 23%); also, a lower incidence of EGFR mutations was detected.

      Conclusion

      High pollution rates are associated with more aggressive tumors and poor prognosis. According with our results, combination of high levels of environmental pollution and smoking had a significant impact in decreased survival. More studies are required to confirm the association between pollution and survival outcomes, also, this study established a baseline to new analysis like massive sequencing of genes to identify associations between NSCLC diagnosis and smoking versus NSCLC and environmental pollution, which could have prognostic and therapeutic implications (eg, response to immunotherapy).

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