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Adnan Aydıner



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    P23 - Mesothelioma, Thymoma and Other Thoracic Malignancies - Esophageal Cancer and Rare Tumors (ID 137)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Mesothelioma, Thymoma and Other Thoracic Malignancies
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P23.02 - Clinicopathological and Prognostic Features of 67 Cases With Pulmonary Sarcomatoid Carcinoma: An 18-Year Single Center Experience (ID 1050)

      00:00 - 00:00  |  Presenting Author(s): Adnan Aydıner

      • Abstract
      • Slides

      Introduction

      The incidence of pulmonary sarcomatoid carcinoma (PSC) is around 0.5% among the subgroups of nonsmall cell lung cancer (NSCLC). PSC has 5 histological subtypes defined by the WHO: pleomorfic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma and pulmonary blastoma. In different series, the age at diagnosis varies between 55-70 years, and it is more common in males and smokers. These tumors' prognosis is poorer, even at an early stage. Nevertheless, promising alternative treatments are on the agenda, with met-amplification and high levels of PD-L1 seen in of these tumors in recent studies. Regarding current information, we evaluated the clinicopathological and prognostic data of patients in our center.

      Methods

      67 patients have been identified in the last 18 years.. Gender, age, and smoking information were recorded. Staging according to 8. edition of TNM was applied from the pre-treatment images. The correlation between the information of surgery, chemotherapy and radiotherapy administered to patients and survival was analyzed. Immunohistochemical (IHC) staining characteristics and pathological findings were taken into account. Overall survival (OS) was primarily targeted in the survival analysis.Multivariate analysis was used to analyze the independent factors on OS.

      Results

      The demographic, clinicopathological and survival data are listed in table 1.

      In accordance with the literature, the disease was more common in men and smokers but demographic factors didn't affect OS. The median OS was found to be statistically poorer in the presence of advanced stage, T4 tumor and lymph node positivity.

      Median OS was significantly higher in patients who had surgery than those who didn't. Those who received adjuvant-neoadjuvant treatment had the best survival among the treatment modalities.

      Tumor subtypes weren't correlated with OS. However, in the subgroup with positive epithelial marker the median OS significantly better than negatives.

      Surgical treatment and stage 4 disease were determined to be independent variables in the multivariate analysis (HR: 0,27 and 3,94 respectively) .

      Table 1: The demographic, clinicopathological and survival data of the patients

      Demographic and clinicopathological data

      Number of patients (%)

      Median OS

      (month)

      5 year survival Rate

      P value

      Gender

      Male

      Female

      50(74.6)

      17 (25.4)

      55.3

      39.3

      %49.8 ± 8.5

      %43.6 ± 13

      0.882

      Age

      <70

      ≥70

      14 (20.9)

      53 (79.1)

      151.9

      25.9

      %51.1 ± 8.1

      %33 ± 14.6

      0.092

      Smoking history

      Yes

      No

      30 (76.9 )

      9 (23.1 )

      -

      44.2

      %57.3 ± 10.6

      %41.7 ± 17.3

      0.417

      Stage (8 th)

      I-II

      III

      IV

      27 (40.3)

      18 (26.9)

      22 (32.8)

      151.9

      54.4

      5.2

      %77 ± 9.2

      %34 ± 14.7

      %15.7 ± 9.5

      0.000

      TNM status (8 th)

      T1-T2-T3

      T4

      38 (62.3)

      23(37.7)

      151.9

      25.9

      %60 ± 9.4

      %38.6 ± 11.4

      0.018

      N0

      N1-N2-N3

      26 (47.3)

      29 (52.7)

      -

      6.8

      %73.5 ± 9.6

      %32.3 ± 10.4

      0.005

      M1a-M1b

      M1c

      5 (22.7)

      17 (77.3)

      4.4

      5.8

      %0 ± 0

      %21.2 ± 11.8

      0.467

      Surgical treatment

      Yes

      No

      42 (62.7)

      25 (37.3)

      151.9

      5.8

      %64.8±9.2

      %16.6 ± 8.3

      0,000

      Treatment modalities

      Adjuvant-neoadjuvant chemoterapy

      Paliative chemoterapy

      Surgery only

      No treatment

      32 (49.2)

      20 (30.8)

      7 (10.8)

      6 (9.2)

      151.9

      12.5

      44.2

      1.9

      %66.7 ± 10.2

      %28.9 ± 11.2

      %47.6 ± 22.5

      %0

      0,000

      Subtype

      pleomorfic carcinoma

      spindle cell carcinoma

      giant cell carcinoma

      carcinosarcoma

      pulmonary blastoma

      Unclassified

      31 (46.3)

      13 (19.4)

      4 (6.0)

      3 (4.5)

      1 (1.5)

      15 (22.4)

      55.3

      39.3

      17.7

      4.4

      -

      -

      %45.9 ± 10.9

      %39.9 ± 14.8

      %37.5 ± 28.6

      %33.3 ± 27.2

      -

      %66.7 ± 12.2

      0.444

      Epithelial markers (TTF-1, napsin-A, P63)

      Positive

      Negative

      11 (39.3)

      17 (60.7)

      -

      6.3

      54.5 ± 23.6

      23.5 ± 10.3

      0.027

      Conclusion

      Because PSC is rare and heterogeneous, it can be challenging and confusing for the clinician. In our retrospective data, early multimodal treatments, especially surgery, can contribute to survival. Because our study is retrospective and included a small sample size, it has limitations, which makes it difficult to evaluate our results. New classifications for the origin of the disease will facilitate treatment and follow-up, and new treatment alternatives will contribute to survival. Larger studies are needed to achieve these goals.

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    P84 - Targeted Therapy - Clinically Focused - ALK (ID 261)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Targeted Therapy - Clinically Focused
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P84.03 - GLASS: Global Lorlatinib for ALK(+) and ROS1(+) Retrospective Study: Real World Data of 123 NSCLC Patients (ID 3172)

      00:00 - 00:00  |  Author(s): Adnan Aydıner

      • Abstract
      • Slides

      Introduction

      Lorlatinib is a third-generation tyrosine-kinases inhibitor (TKI) targeting ALK/ROS1 fusions. The FDA has approved lorlatinib for TKI-pretreated ALK(+) NSCLC, while its approval for ROS1(+) is still pending. Here we present the largest real-world data of NSCLC patients harboring ALK/ROS1 rearrangements treated with lorlatinib.

      Methods

      This is an international, multicenter, retrospective study, which aimed to describe the efficacy and safety of lorlatinib in previously treated ALK/ROS1(+) NSCLC. All patients were treated through an early access program, when no other targeted therapy was available.123 patients were enrolled retrospectively (data cut-off 1/1/2019). Outcome and response were defined by each investigator upon RECIST 1.1 criteria.

      Results

      From March 2015 to January 2019, 106 ALK(+) and 17 ROS1(+) patients were recruited from 8 different countries. The ALK(+) cohort included 50% males, 73% never-smokers and 68% with brain metastases. Extracranial (EC) and intracranial (IC) response rates (RR) were 60% and 62%, with disease control rates (DCR) of 91% and 88% respectively. Mean duration of therapy (DoT) was 23.9±1.6 months and median overall survival (mOS) was 89.1±19.6 months. ROS1 cohort enrolled 53% males, 65% never-smokers and 65% had brain metastases. EC and IC RR were 62% and 67% with DCR of 92% and 78% respectively. Median DoT was 18.1±2.5 months and mOS of 90.3±24.4 months. OS and DoT in both cohorts were not significantly correlated with line of therapy nor other parameters.

      The most common adverse events of any grade were peripheral edema (48%), hyperlipidemia (47%), weight gain (25%) and fatigue (30%). CNS adverse events such as cognitive effect of grade 1-2 were reported in 18% of patients.

      Conclusion

      Lorlatinib shows outstanding extracranial and intracranial efficacy in ALK or ROS1(+) NSCLC. The observed mOS of 89±19 months in ALK(+) NSCLC supports previous reports, while mOS from of 90±24 months is unprecedented for ROS1(+) NSCLC.

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