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Mina Liu
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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
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.04-28 - The Abscopal Effects of the Combination of Radiotherapy and GM-CSF for Patients with Metastatic Thoracic Cancers (Now Available) (ID 1097)
08:00 - 18:00 | Presenting Author(s): Mina Liu
- Abstract
Background
An absopal response was defined as distal tumor regression out of irradiated field induced by radiotherapy and mediated by immune system. Golden EB et al reported a benefit with the use of Granulocyte-macrophage colony-stimulating factor (GM-CSF) with local radiotherapy in a subset of chemotherapy or hormone therapy in patients with metastatic solid tumors. However, the contribution of systemic therapy to abscopal effects couldn’t be defined. Therefore, we conducted the study aiming to evaluate the abscopal effects of the pure combination of local radiotherapy and GM-CSF in patients with metastatic thoracic cancers.
Method
Patients who met the following criteria were included for this study: (1) Pathologic confirmation of thoracic cancer by histology; (2) at least three distinct measurable sites of metastatic disease; (3) received at least one line of previous chemotherapy and had stable or progressing disease to the last chemotherapy or refused to receive chemotherapy; (4) received the combination of GM-CSF and radiotherapy; (5) no previous malignancies; (6) no previous immunotherapy.
Result
A total of 30 consecutive patients who were treated between March 31, 2016 and March 31, 2019 were included in this study. In the 16 patients with lung cancer, 2 partial abscopal responses, 9 stable and 5 progress were observed. In the 10 patients with thymic cancer or thymoma, 2 partial abscopal responses (thymic cancer), 6 stable and 2 progress were seen. Neither of the two patients with esophageal cancer had progressive diseases within 3 months. The patient with tracheal adenoid cystic carcinoma had partial response to the treatment, whereas the other patient with malignant pleural mesothelioma had stable disease. Twenty-four patients (80%) received GM-CSF of 125ug/m2 d8-22, which was the same as Golden EB et al reported. However, 8 patients had high fever (33.3%), 4 patients (16.7%) had edema (Grade 2: 3, Grade 3: 1), 4 patients (16.7%) had dyspnea of Grade 2, and one patient had dermatitis of Grade 3. Another one patient underwent cerebral infarction during the third day of GM-CSF injection. The other 6 patients who had GM-CSF of 70% dosage (87.5ug/m2) had no obvious side effects. No evidence showed that the reduced dosage of GM-CSF may have negative influence on the effect of the treatment.
Conclusion
In conclusion, pure combination of local radiotherapy and GM-CSF may increase the incidence of abscopal responses, and bring benefits to patients with thoracic cancers except esophageal cancer. Lower dosage of GM-CSF is recommended to Asian patients.
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P2.15 - Thymoma/Other Thoracic Malignancies (ID 185)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.15-10 - Clinical Significance of Age at Diagnosis Among Patients with Thymic Epithelial Tumor (Now Available) (ID 1340)
10:15 - 18:15 | Presenting Author(s): Mina Liu
- Abstract
Background
Thymic epithelial tumors (TET) originate in the thymus and include thymomas and thymic carcinomas. These tumors typically occur in adults with a median age of 50, and rare in children or adolescents. Few studies focusing on the effect of age on TET have been reported to date. Whether different age groups have homogeneous clinical features and survival outcomes remains unexplored. This study aimed to compare clinicopathologic characteristics and survival outcomes in different age groups using the Surveillance, Epidemiology, and End Results (SEER) database.
Method
Information of 4431 TET patients was retrieved from the Surveilance, Epidemiology, and End Results (SEER) database. Demographic features, clinicopathologic characteristics and survival outcomes were compared between patients diagnosed at different age groups (0-18, 19-30, 31-40, 41-50, 51-60, 61-70, 71-80, 80+).
Result
A total of 4431 patients were analyzed. Median age was 60-year-old. Twenty-eight (0.6%) patients were aged 1-18, 178 (4.0%) were aged 19-30, 381 (8.6%) were aged 31-40, 742 (16.7%) were aged 41-50, 971 (22.0%) were aged 51-60, 1108 (25.0%) were aged 61-70, 736 (16.6%) were aged 71-80 and 287 (6.5%) were aged 81-90. Gender, race, tumor histology and treatments were similar between different age groups. The 0-18 group was associated with a higher risk of distant metastasis. Compared to patients aged above 80, the hazard ratios of cancer specific survival (CSS) for patients aged 0-18, 19-30, 31-40, 41-50, 51-60, 61-70, 71-80 were 1.079, 0.739, 0.614, 0.621, 0.633, 0.673, and 0.861, respectively. Patients in the 31-40, the 41-50, the 51-60 and the 61-70 age groups had significantly better CSS compared with the 0-18 age group or the 71-80 group or the 81-90 group. From the subgroup analysis, we found that the 19-70 group had significant better CSS and overall survival (OS) than the above 70 group (CSS: p=0.000; OS: p=0.000). Multivariate survival analysis adjusted for gender, race, stage and histology showed that age was an independent prognostic factor for CSS.
Conclusion
Age is a strong independent prognostic factor for survival in TET. Pediatric TET has a higher risk of distant metastasis and an inferior CSS. For the adults, patients older than 70-year-old were associated with a shorter CSS.
