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Oliver Higuera

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    P52 - Staging - Prognosis and Staging (ID 186)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Staging
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P52.06 - “High Tumor Burden” in Metastatic Non-Small Cell Lung Cancer: Defining the Concept (ID 3302)

      00:00 - 00:00  |  Presenting Author(s): Oliver Higuera

      • Abstract
      • Slides


      Identifying patient characteristics that define a worse prognosis for the disease or a “high tumor burden” (HTB) status is essential for clinical decision-making and treatment selection in metastatic non-small cell lung cancer (mNSCLC). This study aimed to define this concept based on the oncologist’s experience in clinical practice.


      A representative sample of Spanish experts was selected and asked to complete an online survey regarding the definition of “high tumor burden” according to their personal experience.


      HTB was identified by the oncologists (N = 81) among the main factors influencing first-line treatment decision-making. According to experts, the number of metastatic lesions (n = 45, 56%), location (n = 34, 42%), tumor size (sum of diameters of target lesions; n = 26, 32%) and liver involvement (n = 24, 30%) mainly defined HTB. High lactate dehydrogenase (LDH) levels were associated with HTB too. Almost half of respondents (n = 33, 41%) believed that one metastatic lesion was sufficient to consider a patient to present HTB, 72% (n = 58) considered that two were necessary and 99% (n = 80) three. Interestingly, liver (n = 76, 100%) followed by brain (n = 65, 86%) were the main metastatic locations associated with HTB. Tumor size ranging from 6 cm to 10 cm as well as high LDH levels (three times above the upper limit) defined the concept for 82% (n = 62) and 100% (n = 76) of oncologists, respectively.

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      In the real-world setting, HTB is defined by the number of metastatic lesions, location of metastases, size of tumors and by high LDH levels according to experts’ opinion. Given the relevance of this concept, efforts should be made to unify its definition, and to further explore its potential as a prognostic factor for mNSCLC patients.

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