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Remei Blanco
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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): Remei Blanco
- Abstract
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: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P52.08 - Thoracic Tumors Registry (RTT): Analysis of Clinical Features and Survival in Patients with mNSCLC in Spain. (ID 3022)
00:00 - 00:00 | Author(s): Remei Blanco
- Abstract
Introduction
The lung cancer is the leading cause of death due to cancer in Western countries, the prognosis it depends on the tumor stage and the clinical, histological and molecular characteristics. The Thoracic Tumors Registry (RTT) of the Spanish Lung Cancer Group is a database who include the data of patients with lung malignant neoplasms.
Methods
The objective of this retrospective study is to descriptive the clinical and epidemiological aspects of non-small cell lung cancer (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 clinical and demographic data are described in the table 1. Adenocarcinoma (72,2%), squamous cell carcinoma (SCC) (18,6%), others types. The sites of metastasis: contralateral lung (34.3%), bone (31%), liver (12.8%) and CNS (6.02%). The first-line of treatment was chemotherapy (CT) in 66,54%, oral target therapy 13,45%, immunotherapy (IO) 8,62% and CT+IO 2,46%. The median of PFS of 7.4 months (7.13-7.6 months) in all population with an estimated at 6, 12, 24, and 60 months of 58.3% (95%CI 56.81% - 59.74%), 29.97% (95%CI 28.56% - 31.4%), 13.4% (95%CI 12.2% - 14.6%) and 2.6% (95%CI 1.98%-3.5%) respectively. The median of OS was 15.5 months (14.8-16.4). According to the histological type (SCC vs non-SCC), the median (in months) of PFS was 6.67 (6.1- 7.1) vs 7.53 (7.3-7.9) (HR 0.78, 95% CI 0.72 - 0.85) and OS 13.8 (12.6-15.6) vs 16.9 (15.7 - 18) in non-SSC, p <0.001. The analysis of survival in patients with or without liver metastasis showed a median OS of 15 months (14.3-16m) vs 18.1 months (16.1- 19.9m), HR 0.88, 95%CI 0.79-0.98 (p<0.05).
N=5049
Age, Median
68,29-y (25-96)
Sex
M: 71,16% - F: 28,83%
Smoking habit
Smoker
Former smoker
Never smoker
42,42%
41,06%
15,56%
Asbestos exposure
2,14%
Patient history of cancer
13,5%
Family history of cancer
40,82%
Conclusion
The results of our study show a similarity in the clinical characteristics of patients with NSCLC in the Spanish population with the data in the western population previously describe. Both the histological subtype and the presence of liver metastases are predictive factors for survival.
