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Ana Blasco



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    FP12 - Tumor Biology and Systems Biology - Basic and Translational Science (ID 188)

    • Event: WCLC 2020
    • Type: Posters (Featured)
    • Track: Tumor Biology and Systems Biology - Basic and Translational Science
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      FP12.01 - Circulating Tumor DNA to the Identification of EGFR Positive NSCLC Long-Term Survivors (ID 3013)

      00:00 - 00:00  |  Author(s): Ana Blasco

      • Abstract
      • Slides

      Introduction

      Survival data supports the use of first-line osimertinib as standard of care for EGFR positive non-small lung cancer (NSCLC). However, it remains unclear whether upfront osimertinib is superior to sequential first- or second-generation tyrosine kinase inhibitor (TKI) followed by osimertinib for all patients. The impossibility of predicting which patients are at high risk of progression constitutes a major limitation of the sequential TKI approach.

      Methods

      Seven hundred and forty-five plasma samples from 192 stage IV, EGFR positive NSCLC patients who were treated with first-line TKI were analysed by digital PCR.

      Results

      Patients with EGFR sensitizing mutations in plasma with mutant allele frequency (MAF) <7% before treatment initiation had median OS 37.9 months (25.3-NR), compared 17.5 (95%CI: 11.3-25.5) months for patients with MAF≥7% (adjusted HR=0.43; 95%CI: 0.25-0.76, respectively). OS was achieved with 53.1% of the patients treated with a 2nd line treatment other than osimertinib. In the multivariable analysis, undetectable levels of circulating tumour DNA (ctDNA) after 3 and 6 months of treatment were associated with improved PFS and OS (P<0.001 in all cases). Patients who became ctDNA negative after 3 or 6 months of treatment with MAF<7% at diagnosis had more than two-thirds lower risk of progression and death compare to the rest of patients (adjusted HR=0.28; 95%CI: 0.17-0.46 and HR=0.24; 95%CI: 0.12-0.48 for PFS and OS, respectively).

      Conclusion

      Pre-treatment ctDNA levels identify patients at low risk of progression and death who could benefit from sequential TKI treatment. Information regarding EGFR sensitizing mutation clearance could improve patient selection.

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    P52 - Staging - Prognosis and Staging (ID 186)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Staging
    • Presentations: 2
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P52.05 - Lung Cancer Symptoms at Diagnosis: Data from the Thoracic Tumors Registry (TTR Study). (ID 3023)

      00:00 - 00:00  |  Author(s): Ana Blasco

      • Abstract
      • Slides

      Introduction

      Lung cancer is the most common cancer worldwide and is the leading cause of cancer death in Western countries. Despite its high incidence and mortality there are few studies that describe its symptoms at diagnosis and their relationship with tumor stage and tobacco use. The objective of this study is to describe the frequency of the most common symptoms of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) at diagnosis and their connection with stage of disease and smoking habit.

      Methods

      This was a case series study that analysed cases collected from the Thoracic Tumour Registry (TTR) sponsored by the Spanish Lung Cancer Group (SLCG) from August 2016 to June 2019.

      Results

      9,876 patients were included. 74% male, the median age was 65 years (57-72), 12% were never smokers. The most frequent histologic type was adenocarcinoma (52%) followed by squamous cell carcinoma (24%) and small cell lung cancer (12.5%). 46.6% of the patients was stage IV at diagnosis. The most common symptoms were cough (33.9%) and dyspnoea (26.7%). No symptom was present in 59% of patients diagnosed stage I NSCLC and in 27.7% of patients stage IV NSCLC. The number of symptoms was similar across the respective smoking categories in NSCLC and differences between the symptoms analysed did not exceed 7% in any case

      TABLE:

      Table. 1 Symptom description by tobacco consumption: NSCLC

      Symptoms at diagnosis+

      Never smokers**

      Ex-smokers**

      Current smokers**

      p-trend

      Cough

      387 (34.1)

      1,310 (31.7)

      1,099 (34.5)

      0.163

      Pain

      318 (28.0)

      990 (24.0)

      1,008 (31.6)

      <0.001

      Dyspnoea

      330 (29.1)

      1,014 (24.5)

      823 (25.8)

      0.365

      Haemoptysis

      70 (6.2)

      511 (12.4)

      389 (12.2)

      <0.001

      Weight loss

      223 (19.7)

      678 (16.4)

      842 (26.4)

      <0.001

      Anorexia

      66 (5.8)

      185 (4.5)

      226 (7.1)

      0.001

      Asthenia

      114 (10.1)

      315 (7.6)

      331 (10.4)

      0.024

      Superior vena cava syndrome

      3 (0.3)

      6 (0.1)

      15 (0.5)

      0.039

      Aphonia or voice alterations

      331 (2.7)

      100 (2.4)

      104 (3.3)

      0.085

      Number of symptoms++

      0

      1

      2

      3

      4 or more

      341 (30.1)

      252 (31.0)

      236 (20.8)

      127 (11.2)

      78 (6.9)

      1,531 (37.0)

      1,121 (27.1)

      812 (19.6)

      427 (10.3)

      242 (5.8)

      879 (27.6)

      887 (27.8)

      694 (21.8)

      454 (14.2)

      272 (8.4)

      <0.001

      0.263

      0.113

      <0.001

      <0.001

      **Never smoker: participant smoked less than 100 cigarettes in lifetime. Ex-smoker: stopped smoking more than 1 year before diagnosis. Current smoker: declared smoking during the year before diagnosis. 89 participants had unknown tobacco consumption.

      +Percentages calculated as a total of the sample.

      ++Totals calculated for each smoking category.

      Conclusion

      In conclusion, this study provides valuable information on the frequency and type of lung cancer symptoms at diagnosis and their relationship with stage and tobacco use. The most relevant findings are that 28% of stage IV lung cancers do not present any symptoms at diagnosis, and that there are no relevant differences in symptom presentation by reference to smoking status. This information confirms the lack of specificity of lung cancer symptoms and the fact that the absence of the most frequent symptoms (i.e., cough, pain, dyspnoea) should in no case lead to a decision to rule out the presence of this disease.

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      P52.10 - Profile of Comorbidities and Cancer History in Patients with mNSCLC in the Spanish Population (Thoracic Tumors Registry). (ID 3024)

      00:00 - 00:00  |  Author(s): Ana Blasco

      • Abstract
      • Slides

      Introduction

      Lung cancer is the most commonly diagnosed cancer worldwide and places a considerable burden on public health. The prognosis depends on the tumor stage and the clinical, histological and molecular characteristics. However, the comorbidities are also an important factor, not only in the diagnostic procedures but on the oncologic treatment strategies. The Thoracic Tumors Registry (RTT) of the Spanish Lung Cancer Group is a database that includes the data of patients with lung malignant neoplasms

      Methods

      The objective of this retrospective study is to describe the profile of comorbidities and cancer history in patients with NSCLC in the Spanish population.

      Results

      The total of patients included in the RTT is 12.897 (Aug 2016 - Jan 2020) and this report is based in the analysis of 5.049 of them. The median of age was 68,9-y (25-96). The most prevalent histology was the adenocarcinoma (72,2%) followed by the squamous cell carcinoma (SCC) (18,6%), others types include sarcomatoids, large cell, neuroendocrine and NOS carcinoma. Seventy-one percent of patients were male and 28,83% female and, according to the smoking habit, 42,42% were smoker, 41,06% former smoker and 15,56% never smoker. The asbestos exposure was informing in 108 cases (2,14%). A total of 4153 patients (82.25%) had comorbidities and these including: hypertension (50,13%), dyslipemia (34,36%), diabetes mellitus (22,9%), COPD (21,04%), heart disease (16,23%), depressive syndrome / anxiety (7,89%), vasculopathy (6,79%), obesity (4,94%), among others. 681 patients had a previous history of cancer (13,49%), the mains include the bladder and urinary tracts (14,39%), head and neck (10,43%), colorectal (10%), breast (8.08%), non-melanoma skin (6,31%), lung (2,5%), lymphoma (2,5%), among others.

      Conclusion

      Our study shows the real comorbidity profiles of patients with NSCLC in Spain. The cardiovascular and pulmonary diseases and the metabolic disorders are the most common pathologies in our patients. Theses comorbidities may have determined the selection of the treatment and influence the prognosis in lung cancer as well as and pose a major clinical challenge in the care of cancer patients.

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