Virtual Library

Start Your Search

Oleksandr Voitko



Author of

  • +

    EP1.05 - Interventional Diagnostics/Pulmonology (ID 195)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Interventional Diagnostics/Pulmonology
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
    • +

      EP1.05-06 - Benefits of 18F-FDG PET/CT-Guided Core-Needle Biopsy in Necrotic or Recurrent Chest Tumors (Now Available) (ID 1019)

      08:00 - 18:00  |  Author(s): Oleksandr Voitko

      • Abstract
      • Slides

      Background

      In case when we have deal with necrotic chest masses and recurrent tumors histological verification become challenged. This happens because CT and ultrasound imaging don’t give us enough information about vital and necrotized part of tumor. CT-guided core-needle biopsy give us possibility to take sample from almost any part of tumor but only with information about density of tissure. On the other hand, 18F-FDG PET/CT give us information about tumor vitality. But usually, 18F-FDG PET/CT performs after morphological verification and we don't use PET/Ct benefits for biopsy.

      Method

      We analyzed 6 patients with chest malignancies: 3 with primary mediastinal lymphoma, 1 – recurrent Hodgkin’s lymphoma, 1 – lung cancer and 1 thymoma. All of them had had at least non-diagnostic core-needle biopsy followed by non-diagnostic thoracoscopic biopsy (1 patient) of Chamberlain procedure (1 patient). We performed PET/CT in all the patients to define the viable target area for subsequent core-needle biopsy. One patient had the biopsy immediately after PET/CT scanning, using the CT-part of PET/CT scanner for navigation. In 5 patients the biopsies were taken within 1 week after PET/CT scanning under normal CT-control. The imaging data obtained from CT and PET/CT scanning were analyzed and compared using the axial slices and MPR reconstructions with OsiriX MD software. 14G and 16G needles were used for mediastinal and lung tumors respectively. All procedures were performed under local anesthesia on outpatient basis.

      Result

      We received tissue confirmation in all cases. No complications occurred during or soon after the biopsy.

      Conclusion

      Uptake zone of the radiotracer on 18F-FDG PET/CT image correlates with informative biopsy specimen taken from that part of the tumor. We may recommend performing of 18F-FDG PET/CT prior to the repeated core-needle biopsy to get information on viable and necrotic tumor compounds to define the target areas.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    PL02 - Presidential Symposium including Top 7 Rated Abstracts (ID 89)

    • Event: WCLC 2019
    • Type: Plenary Session
    • Track:
    • Presentations: 1
    • Now Available
    • +

      PL02.11 - Overall Survival with Durvalumab Plus Etoposide-Platinum in First-Line Extensive-Stage SCLC: Results from the CASPIAN Study (Now Available) (ID 2265)

      08:00 - 10:15  |  Author(s): Oleksandr Voitko

      • Abstract
      • Presentation
      • Slides

      Background

      Extensive-stage (ES)-SCLC is a recalcitrant disease associated with a median OS of ~10 months following etoposide-platinum (EP); new treatments that prolong survival are needed. CASPIAN (NCT03043872) is an open-label, phase 3 study of durvalumab (anti-PD-L1), ± tremelimumab (anti-CTLA-4), combined with EP as first-line treatment for patients with ES-SCLC. Here we report results for durvalumab + EP (D+EP) versus EP from a planned interim analysis.

      Method

      Patients with previously untreated ES-SCLC (ECOG PS 0/1) were randomised (1:1:1) to durvalumab 1500 mg + EP q3w; durvalumab 1500 mg + tremelimumab 75 mg + EP q3w; or EP q3w. Patients in immunotherapy arms received up to 4 cycles of EP followed by maintenance durvalumab until progression. Patients in the EP arm received up to 6 cycles of EP and prophylactic cranial irradiation (PCI), at the investigator’s discretion. Investigator’s choice of cisplatin or carboplatin was allowed across all arms and was a stratification factor at randomisation. The primary endpoint was OS. Data cutoff: 11 March 2019.

      Result

      268 patients were randomised to D+EP and 269 to EP. Baseline characteristics were well balanced between arms. In the EP arm, 56.8% of patients received 6 cycles of EP. At the interim analysis, D+EP significantly improved OS compared to EP with a HR of 0.73 (95% CI, 0.591-0.909; p=0.0047); mOS 13.0 versus 10.3 months, respectively. 33.9% of patients were alive at 18 months with D+EP versus 24.7% with EP. Secondary endpoints of PFS and ORR were also improved with D+EP compared to EP: PFS HR 0.78 (95% CI, 0.645-0.936); mPFS 5.1 versus 5.4 months; 12-month PFS rate 17.5% versus 4.7%; investigator-assessed ORR (RECIST v1.1; unconfirmed) 79.5% versus 70.3% (odds ratio, 1.64 [95% CI, 1.106-2.443]). The incidences of grade 3/4 AEs (61.5% versus 62.4%) and AEs leading to discontinuation (9.4% each) were similar between arms; the incidence of haematological toxicities was numerically higher in the EP arm. The durvalumab + tremelimumab + EP arm continues blinded to final analysis.

      Conclusion

      The addition of durvalumab to EP as first-line treatment for ES-SCLC significantly improved OS (27% reduction in risk of death) versus a robust control arm that permitted up to 6 cycles of EP and PCI. Of note, this chemo-immunotherapy regimen offers flexibility in platinum choice (carboplatin or cisplatin), reflecting current clinical practice for this challenging disease. No new safety signals were identified.

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.