Virtual Library

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    Bayer - Industry Satellite Symposium (ID 43)

    • Event: ELCC 2019
    • Type: Industry Satellite symposium
    • Track:
    • Presentations: 5
    • Now Available
    • Moderators:
    • Coordinates: 4/12/2019, 16:30 - 17:30, Room C
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      Welcome and introduction (Now Available) (ID 650)

      16:30 - 17:30  |  Presenting Author(s): Lukas Bubendorf

      • Abstract
      • Presentation
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      Abstract not provided

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      Emerging data on TRK inhibition in TRK fusion lung cancer (Now Available) (ID 651)

      16:30 - 17:30  |  Presenting Author(s): Alexander Drilon

      • Abstract
      • Presentation
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      Abstract not provided

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      Testing for TRK fusion lung cancer (Now Available) (ID 652)

      16:30 - 17:30  |  Presenting Author(s): Lukas Bubendorf

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      Abstract not provided

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      Ask the experts: Patient cases from TRK inhibitor clinical trials (Now Available) (ID 653)

      16:30 - 17:30  |  Presenting Author(s): Lukas Bubendorf, Alexander Drilon

      • Abstract
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      Abstract not provided

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      Q&A and close (Now Available) (ID 654)

      16:30 - 17:30  |  Presenting Author(s): Lukas Bubendorf, Alexander Drilon

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      Abstract not provided

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    Challenges in clinical oncology: YO case discussions (ID 14)

    • Event: ELCC 2019
    • Type: Educational session
    • Track:
    • Presentations: 7
    • Now Available
    • Moderators:
    • Coordinates: 4/11/2019, 09:00 - 10:30, Room C
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      Introduction (ID 609)

      09:00 - 10:30  |  Presenting Author(s): Radu Adrian Vidra, Jesus Corral

      • Abstract

      Abstract not provided

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      Sequence of ALK patients treatment: A case report (Now Available) (ID 610)

      09:00 - 10:30  |  Presenting Author(s): Paolo Tarantino

      • Abstract
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      Abstract not provided

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      Mentor guided discussion (Now Available) (ID 611)

      09:00 - 10:30  |  Presenting Author(s): Benjamin Besse

      • Abstract
      • Presentation
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      Abstract not provided

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      Role of radiotherapy in oligometastatic I-O progression: A case report (Now Available) (ID 612)

      09:00 - 10:30  |  Presenting Author(s): Fabiana Napolitano

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      Mentor guided discussion (Now Available) (ID 613)

      09:00 - 10:30  |  Presenting Author(s): Suresh Senan

      • Abstract
      • Presentation
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      Abstract not provided

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      Biomarkers in 1L metastatic NSCLC beyond the PD-L1: A case report (Now Available) (ID 614)

      09:00 - 10:30  |  Presenting Author(s): Alicia Quilez Cutillas

      • Abstract
      • Presentation
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      Abstract not provided

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      Mentor guided discussion (Now Available) (ID 615)

      09:00 - 10:30  |  Presenting Author(s): Edurne Arriola Aperribay

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      • Presentation
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      Abstract not provided

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    Current role and future of thoracic radiotherapy (ID 17)

    • Event: ELCC 2019
    • Type: Specialty session
    • Track:
    • Presentations: 4
    • Now Available
    • Moderators:
    • Coordinates: 4/11/2019, 11:00 - 12:30, Room C
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      Early stage NSCLC (Now Available) (ID 43)

      11:00 - 12:30  |  Presenting Author(s): Matthias Guckenberger

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      • Presentation
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      Abstract not provided

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      Locally advanced stage NSCLC (Now Available) (ID 44)

      11:00 - 12:30  |  Presenting Author(s): Jose Belderbos

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      Abstract not provided

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      Oligometastatic NSCLC (Now Available) (ID 45)

      11:00 - 12:30  |  Presenting Author(s): Françoise Mornex

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      Abstract not provided

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      Synchronous and metachronous primary tumours (Now Available) (ID 46)

      11:00 - 12:30  |  Presenting Author(s): Suresh Senan

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      • Presentation
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      Abstract not provided

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    Do we treat patients with I-O until progression? (ID 45)

    • Event: ELCC 2019
    • Type: Controversy session
    • Track:
    • Presentations: 4
    • Now Available
    • Moderators:
    • Coordinates: 4/13/2019, 08:30 - 09:30, Room C
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      Introduction and first vote (Now Available) (ID 108)

      08:30 - 09:30  |  Presenting Author(s): Solange Peters

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      • Presentation
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      Abstract not provided

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      I-O until PD (Now Available) (ID 109)

      08:30 - 09:30  |  Presenting Author(s): David Robert Spigel

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      Abstract not provided

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      I-O fixed-time duration (Now Available) (ID 110)

      08:30 - 09:30  |  Presenting Author(s): Filippo de Marinis

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      • Presentation
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      Abstract not provided

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      Second vote and conclusions (Now Available) (ID 111)

      08:30 - 09:30  |  Presenting Author(s): David Planchard

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      • Presentation
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      Abstract not provided

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    Early detection, screening, prevention (ID 7)

    • Event: ELCC 2019
    • Type: Educational session
    • Track:
    • Presentations: 5
    • Now Available
    • Moderators:
    • Coordinates: 4/10/2019, 14:30 - 16:00, Room C
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      Primary prevention European campaigns (Now Available) (ID 10)

      14:30 - 16:00  |  Presenting Author(s): Silvia Novello

      • Abstract
      • Presentation
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      Abstract not provided

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      e-CIG: Already time to talk about “prevention”? (Now Available) (ID 12)

      14:30 - 16:00  |  Presenting Author(s): Carolyn Dresler

      • Abstract
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      Abstract not provided

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      Low dose CT and secondary prevention: Where we are in Europe (Now Available) (ID 14)

      14:30 - 16:00  |  Presenting Author(s): John K. Field

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      Abstract not provided

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      Early detection of mesothelioma and lung cancer in ultra-high risk populations using a biomarker approach (Now Available) (ID 16)

      14:30 - 16:00  |  Presenting Author(s): Thomas Behrens

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      • Presentation
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      Abstract not provided

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      Biomarkers for early detection (Now Available) (ID 18)

      14:30 - 16:00  |  Presenting Author(s): Nir Peled

      • Abstract
      • Presentation
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      Abstract not provided

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    Medscape Oncology - Industry Satellite Symposium (ID 28)

    • Event: ELCC 2019
    • Type: Industry Satellite symposium
    • Track:
    • Presentations: 6
    • Moderators:
    • Coordinates: 4/11/2019, 18:00 - 19:00, Room C
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      Introduction (ID 632)

      18:00 - 19:00  |  Presenting Author(s): Solange Peters

      • Abstract

      Abstract not provided

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      Testing for ALK-positive disease: The state of the art (ID 633)

      18:00 - 19:00  |  Presenting Author(s): Raffaele Califano

      • Abstract

      Abstract not provided

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      The expanding treatment armamentarium in ALK-positive NSCLC: The evidence (ID 634)

      18:00 - 19:00  |  Presenting Author(s): Marina Chiara Garassino

      • Abstract

      Abstract not provided

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      Case challenge 1: First-line options - Considerations for treatment choice (ID 636)

      18:00 - 19:00  |  Presenting Author(s): Marina Chiara Garassino

      • Abstract

      Abstract not provided

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      Case challenge 2: Second-line treatment selection - How do we choose? (ID 635)

      18:00 - 19:00  |  Presenting Author(s): Raffaele Califano

      • Abstract

      Abstract not provided

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      Conclusions and key points (ID 637)

      18:00 - 19:00  |  Presenting Author(s): Solange Peters

      • Abstract

      Abstract not provided

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    Mini Oral session II (ID 63)

    • Event: ELCC 2019
    • Type: Mini Oral session
    • Track:
    • Presentations: 7
    • Now Available
    • Moderators:
    • Coordinates: 4/11/2019, 16:40 - 17:40, Room C
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      1O - Impact of MET variants on PD-L1 expression in pleomorphic lung carcinoma (Now Available) (ID 495)

      16:40 - 17:40  |  Presenting Author(s): Adam Januszewski  |  Author(s): Yu Zhi Zhang, Wei-Chin Chang, Ute Laggner, Alex Bowman, Toyin Adefila-Ideozu, Igor Vivanco, Miriam F Moffatt, William O Cookson, Nandita P Gupta, Andrew G. Nicholson, Anne Bowcock, Sanjay Popat

      • Abstract
      • Presentation
      • Slides

      Background

      Pleomorphic Lung Carcinoma (PC) is a rare subtype of NSCLCs poorly responsive to systemic therapy. It is a heterogenous tumour with both epithelial and sarcomatoid components. MET variants are targetable aberrations and have recently been reported to be more frequent in PCs. The relationship between MET and PD-L1 expression is not well understood. We determined PD-L1 expression in PCs and its relationship with MET variants.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      80 cases of pleomorphic carcinoma were identified from the biobank and diagnostic archives of Royal Brompton Hospital and Imperial College Healthcare NHS trust. DNA was isolated for determination of a. MET copy number by digital droplet PCR (ddPCR) and b. Genomic MET aberrations by NGS. IHC of PD-L1 (28-8) with % positive cells were scored by two pathologists independently and >49% tumour staining was defined as high.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      78 cases were evaluated for PD-L1 status with a median score of 44%. 23/63 (36%) cases had MET CN of > 2.2. METex14 splice variants were identified in 5/73 (7.2%) cases. 2/73 (2.7%) cases had deleterious MET mutations. By MET CN status: low/normal MET CN (<2.3) median PDL1 expression was higher (50%) than in high MET CN ( > =2.3: 37.5%; P = 0.18). This translates into a significantly fewer number of high PD-L1 expressors (>49%) in cases with high MET CN (>2.2; P = 0.06; Table). There was no significant difference in PDL1 expression between MET mutation vs. wild-type (P = 0.9)

      MET copy number and PDL-1 expression

      PD-L1 ExpressionMET CN < 2.3MET CN > =2.3Total
      PD-L1<50%20 (50%)17 (74%)37
      PD-L1 >50%20 (50%)6 (26%)26
      .

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      PCs have high levels of PD-L1 expression. There is an inverse relationship between MET CN and PD-L1 expression. This has implications when using checkpoint inhibitors for cases with MET copy number gain in NSCLC. Further evaluation is needed to better understand response to checkpoint inhibitors of PC cases with MET CN gain.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The Royal Marsden Foundation NHS Trust.

      213f68309caaa4ccc14d5f99789640ad Funding

      National Institute for Health Research (NIHR) and British Lung Foundation.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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      85O - Prevalence of programmed death ligand-1 (PD-L1) by demographic, disease and sample characteristics in unresectable, stage III NSCLC (PACIFIC) (Now Available) (ID 305)

      16:40 - 17:40  |  Presenting Author(s): David Planchard  |  Author(s): Marina Chiara Garassino, Luis Paz-Ares, Corinne Faivre-Finn, Alexander Spira, Yu Gu, Catherine Wadsworth, Jessica Whiteley, Marietta Scott, Anne-Marie Boothman, Marianne Ratcliffe, Jill Walker, Phillip Andrew Dennis, Scott J. Antonia

      • Abstract
      • Presentation
      • Slides

      Background

      PACIFIC (NCT02125461) was a randomised, placebo-controlled, phase 3 trial evaluating the immune checkpoint inhibitor durvalumab in patients (pts) with unresectable, Stage III non-small cell lung cancer (NSCLC) who did not have disease progression after concurrent chemoradiotherapy (cCRT). Both primary endpoints of progression-free survival and overall survival were met and significantly improved with durvalumab, with similar safety, versus placebo (Antonia et al, NEJM 2017; 2018). We report exploratory analyses of the prevalence of tumour PD-L1 expression by baseline pt, disease and sample characteristics and by response to prior treatment for pts in PACIFIC.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      If available (provision of formalin-fixed paraffin-embedded tumour resection or biopsy samples was optional), archived pre-cCRT tumour tissue was tested retrospectively for PD-L1 tumour cell (TC) expression using the VENTANA PD-L1 (SP263) immunohistochemistry assay and scored at validated pre-specified (≥25%) and post-hoc (≥1%) cutoffs. Overall PD-L1 prevalence (regardless of treatment arm) was summarised by pt subgroups defined by various characteristics, and assessed using a Pearson’s chi-squared test for between-group differences.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Of 713 randomized pts, 451 (63.2%) were evaluable for PD-L1 status. Among PD-L1-evaluable pts, 67.2% (303/451) had TC ≥ 1% and 35.3% (159/451) had TC ≥ 25% (similar to previous reports in metastatic NSCLC). PD-L1 prevalence by various characteristics at the TC ≥ 1% cut-off are reported in the table.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      There were no important differences noted in PD-L1 prevalence between relevant subgroups at the TC ≥ 1% or TC ≥ 25% cut-offs (latter data to be presented). PD-L1 status was unaffected by sample type or age or biopsy location, suggesting expression is stable from pre-cCRT diagnostic biopsies, and supports the use of either primary tumour or lymph node biopsies for PD-L1 testing.

      b651e8a99c4375feb982b7c2cad376e9 Clinical trial identification

      NCT02125461.

      7a6a3ffa2dadc03a6151ee2c4d6fa383 Editorial acknowledgement

      Medical writing support, which was in accordance with Good Publication Practice (GPP3) guidelines, was provided by Andrew Gannon of Cirrus Communications, an Ashfield company, and was funded by AstraZeneca.

      934ce5ff971f1ab29e840a35e3ca96e9 Legal entity responsible for the study

      AstraZeneca.

      213f68309caaa4ccc14d5f99789640ad Funding

      AstraZeneca.

      682889d0a1d3b50267a69346a750433d Disclosure

      D. Planchard: Personal fees: AstraZeneca, Boehringer Ingelheim, BMS, MSD, Pfizer, Novartis, Roche, Celgene, outside the submitted work. M.C. Garassino: Personal fees: AstraZemeca, Roche, BMS, MSD outside the conduct of this study. L. Paz-Ares: Advisory board fees: BMS, Lilly, MSD, AstraZeneca, Roche, Pfizer, Novartis, Incyte, Merk, Boehringer Ingelheim. C. Faivre-Finn: Research funding:AstraZeneca, MSD. A. Spira: Advisory fees, institutional research support: AstraZeneca. Y. Gu, J. Whiteley, M. Scott, J. Walker: Employment, stock: AstraZeneca. C. Wadsworth, P.A. Dennis: Employment, stock: AstraZeneca, outside the conduct of the study. A-M. Boothman: Employment, stock options: AstraZeneca, outside the conduct of the study. M. Ratcliffe: Consultant fees: AstraZeneca, outside the conduct of the study. All other authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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      116O - Health-related quality of life (HRQoL) of non-small cell lung cancer (NSCLC) patients treated with nivolumab in real-life: The EVIDENS study (Now Available) (ID 271)

      16:40 - 17:40  |  Presenting Author(s): Maurice Pérol  |  Author(s): Adrien Dixmier, Fabrice Barlesi, Didier Debieuvre, Christophe Raspaud, Jean Bernard Auliac, Nicolas Benoit, Pierre Bombaron, Denis Moro-Sibilot, Bernard Asselain, François-Emery Cotté, Pauline Lamoureux, Nadine Karam, Nicolas Ozan, Christophe Calvet, Bennett Bryan, Victoria Allan, Clarisse Audigier Valette

      • Abstract
      • Presentation
      • Slides

      Background

      EVIDENS is an observational, prospective, multicenter cohort study following lung cancer patients initially treated with nivolumab between Oct 2016 and Nov 2017 in 146 French centers. Interim efficacy and safety results were consistent with those from nivolumab clinical trials. This analysis describes temporal changes in HRQoL.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      HRQoL was measured using the EQ-5D-3L, a 3-level version consisting of the 5 dimensions descriptive system (EQ-5D) and the visual analogue scale (VAS; 0–100 [worst–best health]). Outcomes for each dimension were described as the proportion of patients with no change, improvement or deterioration, and the utility index and VAS mean changes from baseline (minimally important difference [MID] = 0.08 and ±7 point change, respectively).

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Overall 1,394 NSCLC patients were followed-up for a median of 11.5 months. Baseline characteristics: median age 66.0 years, 69.2% men, 89.6% current/former smokers, 83.2% PS 0-1, 31.1% squamous (SQ) histology. Baseline completion rates for EQ-5D-3L/VAS were 80.2%/77.0%. At 9 and 12 months (276 and 78 patients at risk, respectively), they were 51.4%/48.9% and 69.2%/66.7%, respectively. The table summarizes HRQoL outcomes. Of note, mean change of VAS from baseline was statistically significant at 9 and 12 months regardless of histology and MID was achieved at 12 months for SQ (+7.6 [2.1 ; 13.1]).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Twelve months after initiating nivolumab, all the 5 dimensions measured by EQ-5D-3L were stable in at least half of NSCLC patients and a clinically meaningful improvement of VAS was observed in the SQ patients.

      b651e8a99c4375feb982b7c2cad376e9 Clinical trial identification

      NCT03382496.

      7a6a3ffa2dadc03a6151ee2c4d6fa383 Legal entity responsible for the study

      Bristol-Myers Squibb.

      213f68309caaa4ccc14d5f99789640ad Funding

      Bristol-Myers Squibb.

      682889d0a1d3b50267a69346a750433d Disclosure

      M. Pérol: Boards: Roche, Genentech, Eli Lilly, Pfizer, Boehringer Ingelheim, Clovis Onco, MSD, BMS, Novartis, Pierre Fabre, Takeda, AZ; Symposia: Eli Lilly, Roche, Pfizer, Amgen, Boehringer Ingelheim, BMS, Takeda, AstraZeneca. A. Dixmier: Advisory board: BMS, Roche, Novartis; Support for congress participation: BMS, Roche, AstraZeneca, Boehringer Ingelheim, MSD, Amgen, Lilly. F. Barlesi: Fees: AstraZeneca, BMS, Boehringer Ingelheim, Clovis Oncology, Eli Lilly Oncology, F. Hoffmann-La Roche Ltd, Novartis, Merck, MSD, Pierre Fabre, Pfizer, Takeda. D. Debieuvre: Consulting: Roche; Honoraria as speaker: AstraZeneca, Chugai, Lilly, Roche, Novartis, Pfizer, MSD, BMS; Grant for research: Roche, AstraZeneca, BMS, Boehringer Ingelheim, Chiesi, Chugai, Janssen, Pfizer, MSD, Novartis, GSK, Sandoz; Advisory boards : Roche, Boehringer Ingelheim, Pfizer, MSD, BMS, Novartis; Support for congress participation: Roche, Boehringer Ingelheim, Novartis, Pierre Fabre, Pfizer, Mundipharma, BMS. C. Raspaud: Fees: Novartis, Boehringer Ingelheim, GSK, Chiesi, BMS, MSD, AstraZeneca, SOSO2, AgirAdom, Lilly. J.B. Auliac: Advisory boards: AstraZeneca, Boehringer Ingelheim, BMS, Roche; Speakers bureau: AstraZeneca, Amgen, BMS, Roche, Lilly, Pfizer, MSD. N. Benoit : Fees: BMS, AstraZeneca. P. Bombaron: Fees: BMS, Novartis, Boehringer Ingelheim, Roche, Amgen. D. Moro-Sibilot: Fees: BMS, MSD, Roche, AstraZeneca, Pfizer, Lilly. B. Asselain: Speakers bureau: BMS. F-E. Cotté, P. Lamoureux, N. Karam, N. Ozan, C. Calvet, B. Bryan, V. Allan: Employee: BMS. C. Audigier Valette: Principal investigator : AstraZeneca, Boehringer Ingelheim, BMS, Novartis, Roche, MSD, Pfizer; Consulting: AstraZeneca, Boehringer Ingelheim, BMS, Lilly, Novartis, MSD, Pfizer, Roche AbbVie; Speaker: AstraZeneca, Boehringer Ingelheim, BMS, Lilly, Novartis, Pfizer, Roche, MSD, AbbVie.

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      117O - Racial disparities in characteristics and prognosis in Asian versus white patients receiving atezolizumab: An ancillary analysis of POPLAR and OAK studies (Now Available) (ID 339)

      16:40 - 17:40  |  Presenting Author(s): Jie Qian  |  Author(s): Wei Nie, Jun Lu, Lele Zhang, Yanwei Zhang, Bo Zhang, Shuyuan Wang, Minjuan Hu, Jianlin Xu, Yuqing Lou, Yu Dong, Yanjie Niu, Bo Yan, Runbo Zhong, Wei Zhang, Tianqing Chu, Hua Zhong, Bao-Hui Han

      • Abstract
      • Presentation
      • Slides

      Background

      Racial differences in characteristics and prognosis of Asiatic and White patients receiving immunotherapy have not been well described.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      We studied 390 patients from the POPLAR and OAK studies who received atezolizumab with evaluable biomarker parameters retrieved from a subsequent blood-based study. The differences of Asians versus Whites in baseline characteristics, outcomes and genetic mutations of atezolizumab therapy were assessed.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Asiatic and White patients differed in characteristics including smoking history, baseline sum of the longest diameters (BLSLD), EGFR mutation frequency, programmed death-ligand 1 (PD-L1) expression and blood-based tumor mutational burden (bTMB) level. Overall survival (OS) was longer in Asians compared with Whites before (median OS: 18.7 vs. 11.1 mo; P = 0.005) and after (median OS: 20.9 vs. 12.6 mo; P = 0.005) propensity score matching (PSM). Race was an independent prognostic factor for OS (Asian vs White: HR 0.647, 95% CI 0.447-0.936, P = 0.021) in addition to performance status (PS), histology, BLSLD, and number of metastatic sites. The objective response rate (ORR) for Asians and Whites was 8.2% and 17.1%, respectively and disease control rate (DCR) was 51.2% and 47.7%, respectively. The blood-based mutational landscape differentiated between Asians and Whites. In the overall population, mutations of STK11, EGFR, KEAP1, POLE, GRM3, ATM and STAG2 were associated with treatment response while mutations of TP53, KEAP1, APC, RB1, CREBBP, EPHA5 and STAG2 were associated with OS. Comparing the frequency of efficacy- or prognosis- related mutations, Asians had more EGFR mutations and less TP53 and STK11 mutations than Whites.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Asians and Whites differed in the clinicopathological features and mutational landscape which may explain the superior efficacy of atezolizumab in Asiatic patients with NSCLC. This study conveys implications for further studies on racial disparity in the treatment of immunotherapy.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Support (No. 20161434).

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

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      118O - Blood tumor mutational burden as a predictor of clinical benefit in non-small cell lung cancer patients treated with docetaxel: Secondary analysis of the OAK and POPLAR randomized clinical trials (Now Available) (ID 222)

      16:40 - 17:40  |  Presenting Author(s): Wei Nie  |  Author(s): Jie Qian, Bao-Hui Han

      • Abstract
      • Presentation
      • Slides

      Background

      Blood-based tumor mutational burden (bTMB), which is measured by targeted next-generation sequencing (NGS) using cell-free DNA (cfDNA), shows a positive correlation with tissue-based TMB and is a predictive biomarker for non-small cell lung cancer (NSCLC) patients receiving atezolizumab. However, the role of bTMB in other treatment settings, such as chemotherapy, is unknown. We hypothesized that advanced NSCLC patients with low bTMB would derive more benefit from chemotherapy.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      The clinical and genetic data from docetaxel arm of OAK trial (n = 318, training cohort) and POPLAR trial (n = 106, validation cohort) were used. The FoundationOne CDx NGS assay was used to quantify bTMB. Efficacy was determined by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Durable clinical benefit (DCB) was defined as overall survival (OS) that last more than 12 months. Gene alterations and bTMB were compared among patients with DCB and no durable benefit (NDB). The cut-off value of bTMB for predicting OS was determined by time-dependent receiver operating characteristic (ROC) curve.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Significantly lower bTMB was observed in DCB than NDB (median, 5 vs 9 SNVs/Mb; P < 0.001) and in patients with partial response (PR) versus stable disease (SD) versus progressive disease (PD) (median, 5 vs 7 vs 10 SNVs/Mb; P = 0.007). The optimised cut-off value of bTMB for predicting OS was 7 SNVs/Mb by time-dependent ROC curve. In training cohort, the median OS of patients with low bTMB was 11.5 months and 6.4 months for those with high bTMB (HR 0.638; 95% CI 0.497-0.820; P < 0.001). The median PFS in the low bTMB group (4.3 months) was significantly longer than that in the high bTMB group (2.9 months; HR 0.588; 95% CI 0.466-0.742; P < 0.001). These results were confirmed in validation cohort. Variants in EGFR and KEAP1 associated with DCB and NDB, respectively.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Our data showed that low bTMB (≤ 7 SNVs/Mb) was a clinically biomarker for docetaxel treatment in NSCLC.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

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      119O - Efficacy and safety of nintedanib + docetaxel in lung adenocarcinoma patients (pts) following treatment with immune checkpoint inhibitors (ICIs): First results of the ongoing non-interventional study (NIS) VARGADO (Now Available) (ID 467)

      16:40 - 17:40  |  Presenting Author(s): Judith Atz  |  Author(s): Christian Grohe, Wolfgang Gleiber, Siegfried Haas, Harald Mueller-Huesmann, Mathias Schulze, Rolf Kaiser

      • Abstract
      • Presentation
      • Slides

      Background

      Nintedanib (Vargatef®) is an oral triple angiokinase inhibitor of VEGF-, PDGF- and FGF-receptors approved in the EU and other countries for treatment of locally advanced or metastatic NSCLC of adenocarcinoma histology in combination with docetaxel after 1st line chemotherapy. Data are sparse regarding efficacy and safety of nintedanib in NSCLC pts who had been treated with ICIs.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      This interim analysis included 22 pts with locally advanced or metastatic lung adenocarcinoma who received nintedanib and docetaxel in 3rd line following ICIs in 2nd line within the ongoing NIS VARGADO (cohort B).

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Median age was 58 years (range: 45 – 76), 15/22 pts (68.2%) were men, and 16/22 pts (72.7%) were ECOG PS0/1. 4/22 pts (18.2%) had brain metastases, and 19/22 pts (86.4%) were current or former smokers. 1st line chemotherapy treatments included pemetrexed (15/22 pts, 68.2%), carboplatin (12/22 pts, 54.6%), cisplatin (12/22 pts, 54.6%), bevacizumab (6/22 pts, 27.3%), vinorelbine (4/22 pts, 18.2%), paclitaxel (2/22 pts, 9.1%), and docetaxel (1/22 pts, 4.4%). 2nd line treatments consisted of nivolumab (17/22 pts, 77.3%) or pembrolizumab (5/22 pts, 22.7%). Under nintedanib and docetaxel, 7/12 pts (58.3%) developed a partial response and 3/12 pts (25.0%) showed stable disease; DCR was 83.3% (10/12 pts). Median PFS was 5.5 months (95%CI 1.9 – 8.7). Treatment emergent adverse events (TEAEs) grade ≥3, serious TEAEs, and TEAEs leading to discontinuation were observed in 13/22 pts (59.1%), 11/22 pts (50.0%), and 7/22 pts (31.8%), respectively.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Nintedanib, in combination with docetaxel, showed clinically relevant efficacy and an adequate safety profile in stage IIIB/IV lung adenocarcinoma pts following treatment with chemotherapy and ICIs. Further studies are justified to fully explore the potential of nintedanib and docetaxel in this novel setting. Therefore, anti-angiogenesis plus docetaxel may emerge as a subsequent therapeutic principle in patients progressing under ICI therapy.

      b651e8a99c4375feb982b7c2cad376e9 Clinical trial identification

      NCT02392455.

      7a6a3ffa2dadc03a6151ee2c4d6fa383 Legal entity responsible for the study

      Boehringer Ingelheim Pharma GmbH & Co. KG.

      213f68309caaa4ccc14d5f99789640ad Funding

      Boehringer Ingelheim Pharma GmbH & Co. KG.

      682889d0a1d3b50267a69346a750433d Disclosure

      C. Grohe: Research funding/honoraria: AbbVie, AstraZeneca, Bayer, Boehringer Ingelheim, MSD, Pfizer, Hoffmann-La Roche, Lilly including membership on advisory boards. W. Gleiber: Honoraria for membership on advisory boards: Boehringer Ingelheim. J. Atz, R. Kaiser: Employee: Boehringer Ingelheim Pharma GmbH & Co. KG All other authors have declared no conflicts of interest.

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      189O - EGFR-TKIs plus bevacizumab demonstrated survival benefit than EGFR-TKIs alone in EGFR-mutant NSCLC patients with multiple brain metastases (Now Available) (ID 234)

      16:40 - 17:40  |  Presenting Author(s): Tao Jiang  |  Author(s): Caicun Zhou

      • Abstract
      • Presentation
      • Slides

      Background

      Brain metastasis (BM) is the intractable disease in patients (Pts) with advanced non-small-cell lung cancer (NSCLC). Previous studies reported that EGFR-TKI plus bevacizumab (Ebe) could result in a significant prolongation of progression-free survival (PFS) than EGFR-TKI (E) alone. This study aimed to investigate whether Ebe could provide survival benefit than E alone in EGFR-mutant NSCLC Pts with BM.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Pts with EGFR-mutant NSCLC and radiologically confirmed BM (number > 3) were included. Pts with liver or leptomeningeal metastases were excluded. Intracranial PFS (iPFS) was defined as the time from the date of initiation of 1st treatment to the date of intracranial progression or death and was censored at the date of last tumor assessment (when carried out). Systemic PFS (sPFS) was defined as the time from the date of initiation of 1st treatment to the date of systemic progression (except intracranial progression) or death and was censored at the date of last tumor assessment (when carried out).

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      164 Pts were identified. 121 received E and 43 received Ebe as 1st treatment. Response rate was marginally higher in Ebe group than that in monotherapy group (69.7% vs. 52.9%, P = 0.055). Ebe was associated with a significantly longer iPFS (13.5 vs. 7.3 m, P < 0.001) and sPFS (14.4 vs. 8.8 m, P < 0.001) than E monotherapy. Importantly, median OS was markedly longer in Ebe group than in E group (30.1 vs. 22.4 m, P < 0.001). Different types of EGFR-TKIs showed comparable efficacy when combined with bevacizumab. However, erlotinib was associated with a significantly longer iPFS but similar sPFS and OS when compared with gefitinb and icotinib monotherapy. Multivariate analysis revealed that addition of bevacizumab was independently associated with prolonged iPFS (HR = 0.45, P < 0.001), sPFS (HR = 0.47, P < 0.001) and OS (HR = 0.50, P < 0.001).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      The current study indicated that Ebe demonstrated the prolonged survival benefit than E alone in EGFR-mutant NSCLC Pts with multiple BM. These findings suggest that this strategy should be further explored in large-scale, strictly designed clinical trials as a standard treatment option in this clinical scenario.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

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    Mini Oral session III (ID 65)

    • Event: ELCC 2019
    • Type: Mini Oral session
    • Track:
    • Presentations: 8
    • Now Available
    • Moderators:
    • Coordinates: 4/12/2019, 17:45 - 18:45, Room C
    • +

      2O - Differentially regulated high-throughput CT imaging features correlate to distinct tumor immune contextures portraying a radiomic signature with prognostic impact on surgically resected NSCLC (Now Available) (ID 507)

      17:45 - 18:45  |  Presenting Author(s): Giulia Mazzaschi  |  Author(s): Federico Quaini, Gianluca Milanese, Denise Madeddu, Giovanni Bocchialini, Luca Ampollini, Letizia Gnetti, Costanza Lagrasta, Mario Silva, Giovanni Roti, Nicola Sverzellati, Marcello Tiseo

      • Abstract
      • Presentation
      • Slides

      Background

      The ground-breaking advent of immunotherapy in the oncologic arena still leaves uncovered the identification of valid prognostic and predictive biomarkers. To this aim, we advanced the hypothesis that intersecting the tumor immune microenvironment (TIME) with high-throughput extracted radiomic features may identify NSCLC patients with distinct clinical outcome.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      We enrolled 60 surgically resected NSCLC patients. TIME was assessed by the quantitative evaluation of PD-L1 levels and an extensive morphometric analysis of Tumor Infiltrating Lymphocytes (TILs). From each CT scan, in addition to semantic characteristics, 841 radiomic features were extracted through an open-source (3d Slicer) software. Radiomic variables were subjected to statistical analysis to test their correlation with tissue immune profiles and survival outcome.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      A cluster of 3 patients (A) displaying oppositely regulated radiomic features was identified by an unsupervised hierarchical model. Compared to the remaining cases, cluster A had a significantly reduced (p < 0.01) OS (13 vs 33 mos.) and DFS (11 vs 25 mos.) and shared similar semantic imaging characteristics (no effect on parenchyma and subsolid texture) and a desertic TIME (PD-L1low and TILslow). Radiomic variables from cluster A were then compared to those extracted from patients matched for both desertic TIME and qualitative CT parameters but with favorable survival outcome (cluster B). By applying signal-to-noise ratio and T-test, the most significant oppositely regulated wavelet features (p < 0.0001) in the two clusters were Large Dependence Emphasis, Busyness, Cluster-Tendency and Gray Level Variance. The detailed analysis of corresponding TIME revealed that PD-1-to-CD8 ratio was the only immunophenotypic parameter differentially expressed by the two prognostic classes.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Higher order radiomic features associated with specific TILs phenotype may enclose a radiologic signature with prognostic impact on NSCLC.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      University Hospital of Parma.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

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      42O - Implementation of organized lung cancer screening program in Korea (Now Available) (ID 608)

      17:45 - 18:45  |  Presenting Author(s): Yeol Kim

      • Abstract
      • Presentation
      • Slides

      Background

      Lung cancer is the leading cause of cancer mortality worldwide and has a low survival rate due to difficulties cocnerning early detection. The Korean Lung Cancer Screening demonstration project (K-LUCAS) was started in February 2017. K-LUCAS will assess the effectiveness, harm, and feasibility of lung cancer screening in order to implement a population-based screening program. K-LUCAS will evaluate the validation of the new standard of reporting form of low-dose computed tomography (LDCT) and the quality of lung cancer screening by a web-based network system using computer-aided nodule detection program (CAD).

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      K-LUCAS is a population-based single arm trial conducted in 14 cancer hospitals that targets a high-risk population aged 55-74 years with at least 30 pack-year smoking history within the last 15 years. Participants were recruited when visiting the national cancer screening center or smoking cessation clinics based on a lung cancer risk evaluation questionnaire. Lung cancer screening was provided by LDCT with at least a 16-row multidetector CT scanner and screening results were reported by Lung Imaging Reporting and Data System (Lung-RADS). All participants should have their results explained to them by a physician and current smokers should receive smoking cessation counselling.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Up until November 2018, 13,491 participants had joined K-LUCAS. The positive screening rate (categories 3 and 4 in Lung-RADS) was 15.3%. Among these, 69 lung cancers were detected and stage I and II lung cancers were 53.6% and 15.9%, respectively. CAD detects more positive findings but decreases the variation of positive rate among screening units. About 75% of abnormal findings, including emphysema, coronary artery calcification etc. besides lung nodules, were detected in K-LUCAS.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      K-LUCAS shows promising results in effective detection of early stage lung cancer and controlling diagnosis quality by a web-based network system. Based on the observations from K-LUCAS, a decision will be made as to whether lung cancer screening will be included in national cancer screening program.

      b651e8a99c4375feb982b7c2cad376e9 Clinical trial identification

      NCT03394703.

      7a6a3ffa2dadc03a6151ee2c4d6fa383 Legal entity responsible for the study

      The author.

      213f68309caaa4ccc14d5f99789640ad Funding

      Ministry of Health and Welfare, Republic of Korea.

      682889d0a1d3b50267a69346a750433d Disclosure

      The author has declared no conflicts of interest.

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      43O - Baseline results from a French pilot study on lung cancer screening by CT scan: DEP KP80 (Now Available) (ID 317)

      17:45 - 18:45  |  Presenting Author(s): Olivier Leleu  |  Author(s): marie-anne Auquier, Bruno Chauffert, pascal Berna, valerie Petigny, amale Ait Addi, damien Basille, vincent Jounieaux

      • Abstract
      • Presentation
      • Slides

      Background

      Lung cancer is the leading cause of cancer death worldwide. Two large randomized controlled trials (NLST,NELSON) founded a significant decrease in lung cancer mortality with an annual low dose CT screening among selected current or former smockers.While being now recommended in many countries, the French National Authority for Health claimed that conditions were not sufficient for implementation of such a screening program in France. The aims of our study were to assess the feasibility and effectiveness of a lung cancer screening pilot program with LD CT scan in a French department. We report here the results of the first screening round.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      DEP KP80 was a single-arm, prospective study started in May 2016 and ended in December 2018 in a French department (Somme). The inclusion criteria were those of the NLST study. An annual LD CT scan was scheduled and 2 rounds were planned. Our algorithms considered nodules<5mm as negative, nodules> 10mm as positive and recommended a 3-month CT with measurement of the doubling time for nodules between 5 and 10 mm . Smoking cessation was encouraged as part of the protocol. This study was managed by the departmental cancer screening agency (ADEMA80). All General Practitioners (GP), pulmonologists (PN) and radiologists from the department were solicited by mail to participate in this study. Subjects were selected by GP or PN who checked the inclusion criteria and precribed the CT scan.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      218 GP, 17 PN and 28 radiologists accepted to participate. Over a 2.5 years period, 1307 subjects were recruited. the participation rate was of 73% (949 scans were performed). Screening was negative in 733 cases (77%), positive in 54 (5.7%) and indeterminate in 162 (17%). The prevalence of a detected lung cancer was 2.5% : 24 cancers with 16 adenocarcinomas,3 squamous cell carcinomas, 1 carcinoid tumour, 2 small cell carcinomas 1 undetermined and 1 unknown. There were 2 carcinoma in situ (8%),13 Stage IA (54%), 3 Stage IIB (12%), 2 Stage IIIA (8%) and 4 Stage III B,C (17%). A surgery was performed in 20 of these patients (83%) and one patient underwent surgery for benign lesion.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      This study demonstrates, at a regional level, the feasibility and effectiveness of an organized and structured lung cancer screening by LD CT scan in France.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      O. Leleu.

      213f68309caaa4ccc14d5f99789640ad Funding

      La ligue contre le cancer Agence Régionale de Santé Picardie and AstraZeneca.

      682889d0a1d3b50267a69346a750433d Disclosure

      All other authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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      70O - Radiomic-based quantitative CT analysis to predict the invasiveness of pure ground-glass lung adenocarcinoma (Now Available) (ID 244)

      17:45 - 18:45  |  Presenting Author(s): Fangyi Xv  |  Author(s): Wenchao Zhu, Hongjie Hu

      • Abstract
      • Presentation
      • Slides

      Background

      Lung cancer is till one of the leading causes of cancer-related deaths and lung adenocarcinoma is the most common type. Compared with invasive adenocarcinoma, adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) are considered as indolent lung adenocarcinoma with good prognosis. However, AIS, MIA and even some early-stage invasive adenocarcinoma can be shown as pure ground-glass nodules on computed tomorgraphy images, which is quite difficult for clinicians to make a precise diagnosis and a suitable treatment plan. Thus, we aim to investigate the performance of radiomic-based quantitative analysis on CT images in identifying invasiveness of lung adenocarcinoma manifesting as pure ground-glass nodules.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      275 lung adenocarcinoma cases with 322 pure ground-glass nodules from January 2015 to October 2017 were enrolled in this retrospective study. All lesions were resected surgically and confirmed pathologically. Clinical data like age , gender, smoking status of all cases were collected from digital medical records. Radiomic feature extraction was performed using Python with semi-automatically segmented tumor regions on CT scans which was contoured with an in-house developed plugin for 3D-Slicer. The predictive performance of the prediction models was evaluated through the receiver operating characteristic curve (ROC).

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Among 322 nodules, 48(15%) were Adenocarcinoma in situ (AIS), 102(32%) were minimally invasive adenocarcinoma (MIA) and 172(53%) were invasive adenocarcinoma. All nodules were divided into training and validation cohort randomly with a ratio of 2:1 to establish prediction models. The values of the area under the curve were 0.716 (95%CI:0.600∼0.832) and 0.827 (95%CI:0.729∼0.925) with the diagnostic accuracy of 59.3% and 69.1% for radiomic and combined models, respectively.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Radiomic model built via quantitative CT analysis can help to identify the invasiveness of lung adenocarcinoma represented as pure ground-glass nodules. Combining this model with clinical features can significantly improve its prediction performance.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      Fangyi Xv.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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      71O - Impact of underlying pulmonary diseases on treatment outcomes in early stage non-small cell lung cancer treated with definitive radiotherapy (Now Available) (ID 152)

      17:45 - 18:45  |  Presenting Author(s): Hakyoung Kim  |  Author(s): Hongseok Yoo, Hongryull Pyo, Hye Yun Park

      • Abstract
      • Presentation
      • Slides

      Background

      Current guidelines recommend definitive radiotherapy for patients with medically inoperable early stage non-small cell lung cancer (NSCLC). However, impact of underlying pulmonary diseases on survival of those patients are unclear. Especially, although the patients with COPD and lung cancer have worse prognosis than those without COPD regardless tumor stage, the impact of coexisting COPD on treatment outcome after definitive radiotherapy has not been fully investigated. Thus, we aimed to evaluate the impact of underlying chronic pulmonary disease of COPD, IPF, and CPFE on treatment outcome following definitive radiotherapy in patients with medically inoperable stage I-II NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      We retrospectively reviewed the medical records of 234 patients with stage I-II NSCLC treated with definitive radiotherapy alone at Samsung Medical Center, between January 2010 and October 2017. We compared the survival outcomes according to the presence of underlying pulmonary diseases of chronic obstructive pulmonary disease (COPD), combined pulmonary fibrosis and emphysema (CPFE), and idiopathic pulmonary fibrosis (IPF). In current study, we defined control group as non-COPD, non-CPFE, and non-IPF.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Among 234 study patients, 132 (56.4%) were diagnosed with COPD, 16 (6.8%) with CPFE, and 22 (9.4%) with IPF. The median follow-up duration was 17 months (range, 1 to 92 months). The median survival of control, COPD, CPFE, and IPF groups were 32, 49, 17, and 12 months, respectively (P < 0.001). In a Cox proportional hazards analysis for factors associated with overall survival, patients with COPD showed similar risk of death (Adjusted HR, 1.314; 95% CI, 0.677-2.551; p-value= 0.419) compared to control group, while patients with IPF (Adjusted HR, 3.539; 95% CI, 1.647-7.607; p-value= 0.001) and CPFE (Adjusted HR, 2.669; 95% CI, 1.095-6.505; p-value= 0.031) showed increased risk of death.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Definitive radiotherapy may be a tolerable treatment for early-stage NSCLC with COPD. However, the poor survival in early-stage NSCLC patients with co-existing IPF or CPFE warrants further study to identify and develop patient selection criteria and optimal radiotherapy modality.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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      72O - Multi-centre analysis of cardiac events following radical radiotherapy for lung cancer (Now Available) (ID 235)

      17:45 - 18:45  |  Presenting Author(s): Fei Sun  |  Author(s): Kathryn Banfill, John Lilley, Bob Wheller, Louise Murray, Alan McWilliam, Marcel Van Herk, Azadeh Abravan, Corinne Faivre-Finn, Kevin Nicholas Franks

      • Abstract
      • Presentation
      • Slides

      Background

      Radical radiotherapy (RRT) plays an essential role in the management of early and locally advanced lung cancer. Recent studies suggest cardiac events post radiotherapy worsen survival outcome for patients. This study aims to identify risk factors which predispose patients to cardiac events post radiotherapy.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      All patients who received RRT (including Stereotactic Body Radiotherapy (SBRT), radical fractionated radiotherapy and chemoradiotherapy) for lung cancer between 01/01/2010 to 30/12/2016 at 2 UK institutions have been included. Patients were excluded if they had multiple courses of radiotherapy to the chest. Individual patient clinical information has been retrieved from hospital electronic database. Patient and cancer demographics have been collected. Pre-existing cardiac conditions, Charlsons’ Co-morbidity index and Qrisk 3 scores were calculated. Post radiotherapy cardiac events were identified rom electronic patient records and time to cardiac events were calculated.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      600 patients have been identified so far and processed. Median follow up is 31 months. Of all patients, 29% had pre-existing cardiac conditions. 52 patients experienced cardiac events following radiotherapy, of which 37% were ischaemic events. Of patients who experienced an ischaemic event, 58% did not have a known pre-existing cardiac condition. 71% of cardiac events post RRT occurred in the first 2 years following RT. Proportionally, patients who underwent radical fractionated radiotherapy and concurrent chemoradiotherapy had the highest incidence of cardiac events. Patient characteristics of those who experienced cardiac toxicity are summarized in the table below

      Total = 52 (10%)Ischaemic events19 (7 events lead to death – Grade 5)
      Pericardial(effusion) events8
      Arrhythmic events13
      Cardiac failure events12
      Pre-existing cardiac diagnosisPatients who had ischaemic events8/19 (4 previous MI, 2 IHD, 1 arrythmia and 1 valve abnormality
      Patients who had pericardial events1/8 (arrhythmia)
      Patients who had arrhythmic events6/13 (2 previous MI, 2 IHD, 1 CCF, 1 CCF and arrhythmia)
      Patients who had CCF events9/12 (2 previous MI, 5 IHD, 2 valvular abnormality)
      SexMale = 33 Female = 19
      AgeMedian = 73
      SmokingNever smoked0
      Ex-Smoker <10 PY0
      Ex-smoker <20 PY9
      Ex-Smoker 20-40PY15
      Ex-Smoker >40 PY9
      Current Smoker19
      Charlson ScoreMedian = 6
      RT indicationAdjuvant RT4 (12.5% of all Adjuvant RT)
      SBRT19 (8.7% of all SBRT)
      Concurrent ChemoRT10 (14.5% of all Concurrent ChemoRT)
      Sequential ChemoRT0
      Radical Fractionated RT19 (15.6% of all Radical Fractionated RT)
      Tumour LocationLeft Upper Lobe(LUL)12 (8% of all LUL tumours)
      Left Lower Lobe(LLL)11 (17% of LLL tumours)
      Right Upper Lobe(RUL)16 (9% of RUL tumours)
      Right Middle Lobe(RML)1 (3% of RML tumours)
      Right Lower Lobe(RLL)12 (17% of RLL tumours)
      .

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      A clinically significant proportion of patients developed cardiac toxicity following radical radiotherapy for lung cancer. Cardiac events occur much sooner after lung cancer radiotherapy than radiotherapy for breast cancer or lymphoma. Work is ongoing to identify greater number of patients and combine local data with data from national registry to aid analysis.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Yorkshire Cancer Research.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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      86O - The effect of prophylactic cranial irradiation (PCI) for young stage III NSCLC patients: Subgroup analyses of the NVALT-11/DLCRG-02 study (Now Available) (ID 524)

      17:45 - 18:45  |  Presenting Author(s): Willem J.A. Witlox  |  Author(s): Bram Ramaekers, Harry J.M. Groen, Anne-Marie C. Dingemans, John Praag, Jose Belderbos, Vincent Van der Noort, Harm Van Tinteren, Manuela A. Joore, Dirk De Ruysscher

      • Abstract
      • Presentation
      • Slides

      Background

      The NVALT-11/DLCRG-02 phase III study compared PCI to observation after chemo-radiotherapy (RT) for stage III NSCLC and showed a significant decrease in the cumulative incidence of symptomatic brain metastases (BM) in the PCI arm at two years (7% vs 27% [HR 0.23]). We here performed exploratory subgroup analyses.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Two year cumulative incidence rates were calculated and competing risk regression, with death of any cause as competing risk, was used to examine the time to symptomatic BM in the following subgroups: age, gender, performance status, disease stage and tumour type, prior surgery, chemotherapy cycles, thoracic RT dose and total concurrent chemo-RT treatment time. For continuous variables, the median was used as a cut-off value. The effect of PCI was only examined if the initial result was significant.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      In total, 174 patients were analysed. The symptomatic BM incidence was significantly lower in the subgroup of older (>61 years) versus younger ( = <61 years) patients (7% vs 26% [HR 0.25]). Stratified by age, PCI only significantly reduced the symptomatic BM incidence in younger patients (9% vs 42% [HR 0.18])(Table).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      The symptomatic BM incidence was significantly lower in older (>61 years) compared to younger ( = <61 years) patients, likely due to higher numbers of adenocarcinoma in the younger patients group. The effect of PCI was only significant in younger patients. This study was randomized based on treatment allocation and subgroups might be too small to detect significant differences. Therefore, our results are hypothesis generating and should be prospectively tested.

      b651e8a99c4375feb982b7c2cad376e9 Clinical trial identification

      NCT01282437.

      7a6a3ffa2dadc03a6151ee2c4d6fa383 Legal entity responsible for the study

      Nederlandse Vereniging van Artsen voor Longziekten en Tuberculose (NVALT).

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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      120O - Thromboembolic events in advanced non-small cell lung cancer (Now Available) (ID 312)

      17:45 - 18:45  |  Presenting Author(s): Vijay Kumar Srinivasalu  |  Author(s): Narayana Subramaniam, Saadvik Raghuram, sarada Kolathu, bharadwaj Ponnada, Arun Philip, Wesley Mannirathil Jose, Keechilat Pavithran

      • Abstract
      • Presentation
      • Slides

      Background

      Cancer is a prothrombotic condition and its treatment is often complicated in the presence of thromboembolisms (TE) which adds to its morbidity and mortality. We aimed to assess the incidence of TE’s in patients with NSCLC treated at our institute.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      A retrospective observational study of patients with NSCLC treated between January 2011 and December 2016 were included. Time of onset of TE’s either at diagnosis or after the start of platinum-based chemotherapy was noted, Khorana score was calculated in all patients with TE’s. A TE occurring between first dose of chemotherapy and 4 weeks after the last dose was considered to be chemotherapy associated.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      On analysis of records from the EMR, we found a total of 1542 NSCLC patients who were treated at our institute, with a male to female ratio of 3.5 : 1. All patients with TE’s had stage IV disease at the time of presentation. Fifty-nine (3.8%) patients out of 1542 developed TE’s, 53 had venous TE and 6 had cerebral arterial infarction. Twenty-five (1.6%) had TE’s at the time of diagnosis while 34 (2.9%) out of 1180 developed TE while on treatment with platinum based chemotherapy. The mean age was 60 years (Range:34-81 yrs) with a male predominance (59%). Majority of patients developed TE’s within 100 days from the start of chemotherapy with a median time of 66 days. (Range:14-143 days) Intermediate and high risk groups on assessment of Khorana score was 61% and 39% respectively. The median overall survival for patients with TE was 129 days in comparison to 234 days for patients without thromboembolisms.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Thromboembolism is associated with a poor prognosis in patients with advanced lung cancer. Patients receiving platinum-based chemotherapy are predisposed to higher incidences of thromboembolic events which raises a valid question of the need of thromboprophylaxis in a selected group of patients.

      b651e8a99c4375feb982b7c2cad376e9 Clinical trial identification

      It is not a clinical trial

      7a6a3ffa2dadc03a6151ee2c4d6fa383 Legal entity responsible for the study

      Amrita Institute of Medical Science.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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    Optimal management of brain metastases in NSCLC (ID 47)

    • Event: ELCC 2019
    • Type: Educational session
    • Track:
    • Presentations: 4
    • Now Available
    • Moderators:
    • Coordinates: 4/13/2019, 09:40 - 11:10, Room C
    • +

      Is there still a role for surgery? (Now Available) (ID 117)

      09:40 - 11:10  |  Presenting Author(s): Michael Weller

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      The role of brain irradiation (Now Available) (ID 118)

      09:40 - 11:10  |  Presenting Author(s): Corinne Faivre-Finn

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      Sequencing systemic therapy without driver mutations (Now Available) (ID 119)

      09:40 - 11:10  |  Presenting Author(s): Natasha Leighl

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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      Sequencing systemic therapy with driver mutations (Now Available) (ID 120)

      09:40 - 11:10  |  Presenting Author(s): Edurne Arriola Aperribay

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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    Pfizer Oncology - Industry Satellite Symposium (ID 37)

    • Event: ELCC 2019
    • Type: Industry Satellite symposium
    • Track:
    • Presentations: 5
    • Moderators:
    • Coordinates: 4/12/2019, 13:00 - 14:00, Room C
    • +

      Introduction (ID 655)

      13:00 - 14:00  |  Presenting Author(s): Enriqueta Felip

      • Abstract
      • Slides

      Abstract not provided

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      Where did we start? (ID 656)

      13:00 - 14:00  |  Presenting Author(s): Enriqueta Felip

      • Abstract

      Abstract not provided

    • +

      Where are we now and what is on the horizon? (ID 657)

      13:00 - 14:00  |  Presenting Author(s): Shobhit Baijal

      • Abstract

      Abstract not provided

    • +

      How can we make balanced treatment decisions for our EGFR+ patients? (ID 658)

      13:00 - 14:00  |  Presenting Author(s): Nicolas Girard

      • Abstract

      Abstract not provided

    • +

      Q&A (ID 659)

      13:00 - 14:00  |  Presenting Author(s): Enriqueta Felip

      • Abstract

      Abstract not provided