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S. Okazawa



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    P2.10 - Poster Session 2 - Chemotherapy (ID 207)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 2
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      P2.10-024 - Usefulness of creatinine/cystatin C ratio as a predictive marker for adverse effects of chemotherapy. (ID 1513)

      09:30 - 09:30  |  Author(s): S. Okazawa

      • Abstract

      Background
      Cystatin C has often been used as a marker of renal function and rarely is influenced by muscle mass, whereas the Creatinine/cystatine C ratio (Cr/CysC) is influenced by muscle mass. However, it is unknown if the Cr/CysC ratio can be used as a predicitive marker for adverse side effects of chemotherapy. The aim of this study is to if the Cr/CysC ratio can be used as a predictive marker for adverse effects of chemotherapy.

      Methods
      We measured cystatin C levels in 25 patients with either non-small cell cancer (NSCLC) or small cell lung cancer (SCLC) as a marker of renal function at the initial commencement of chemotherapy and conducted a retrospective comparative study utilizing the Cr/CysC ratio and clinical data.

      Results
      Patient characteristics were as follows: median age = 67 years (age range 54-84 years; age 70 ≤ 10 out of 15 cases); male:female = 23:3; NSCLC:SCLC = 18:7; ECOG PS 0-1:2 = 22:3. Epidermal growth factor receptor (EGFR) genetic mutation was observed in one case, was not present in 13 cases, and the remaining 11 cases were unknown. Twenty two cases were in the first line therapy, and 3 cases were in the second line therapy. The ratio of platinum-based combination to single agent therapy was 20:5 cases. NSCLC patients with toxicity grades over 3 had hematological toxicity (n = 4, 22.2%) and non-hematological toxicity (n = 3, 16.7%). All SCLC patients with toxicity grades over 3 had hematological toxicity (n = 7, 100%) while non-hematological toxicity wasn’t present (n = 0, 0%). There were no significant differences between the Cr/CysC ratios in patients > 70 years. There was a highly significant difference in the Cr/CysC ratios in patients with NSCLC and patients with SCLC (0.92 vs 0.78, p < 0.05). There was significant difference between Cr/CysC ratios in patients with toxicity grade over 3 and under 2 (0.84 vs 0.70, p<0.05), and this trend was also shown in the confined platinum-based combination therapy group (0.85 vs 0.69, p < 0.05).

      Conclusion
      The Cr/CysC ratio could prove useful as a predictive marker for adverse effects of chemotherapy in patients with NSCLC.

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      P2.10-027 - Mutation of epidermal growth factor receptor gene and efficacy of gefitinib in squamous cell carcinoma of lung (ID 1582)

      09:30 - 09:30  |  Author(s): S. Okazawa

      • Abstract

      Background
      The epidermal growth factor receptor (EGFR) gene mutation has been reported as an important predictive factor for EGFR-tyrosine kinase inhibitor (TKI) efficacy in NSCLC. In "The Lung Cancer Diagnosis and Treatment Guideline published by The Japan Lung Cancer Society 2012 edition", the EGFR gene mutation is strongly recommended to be analyzed in deciding the treatment policy of advanced non- squamous cell carcinoma. In addition, it is known that the EGFR gene mutation is frequently observed in adenocarcinoma (Ad), but very rare in squamous cell carcinoma (Sq). Efficacy of EGFR-TKI in EGFR gene mutation positive Sq has not examined enough.

      Methods
      We obtained tumor samples from 50 patients diagnosed as Sq (excluded Ad-Sq carcinoma) by two or more pathologist between January 2008 to March 2013. The EGFR gene mutation status was determined by PCR-Invader assay (BML Incorporation) and direct sequencing method.

      Results
      EGFR gene mutations were detected in 2 of 50 (4%) samples. Common characteristics of two patients were male, elderly, high level of CEA, and good PS. One patient was an on-smoker and the other was a heavy smoker. The type of the EGFR gene mutation was both exon 21 point mutation. Gefitinib was administered to two patients and PRs were observed. Their progression-free-suvival were 9 months and 20 months.

      Conclusion
      The frequency of the EGFR gene mutation in Sq was low. However, it was suggested that gene mutation positive Sq is responded to EGFR-TKI. It is necessary to analyze the EGFR gene mutation in Sq.