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H. Domínguez Malagón



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    P2.18 - Poster Session 2 - Pathology (ID 176)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Pathology
    • Presentations: 1
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      P2.18-023 - Relevance of the novel IASLC/ATS/ERS classification of lung adenocarcinoma in advanced-disease non-small cell lung cancer. (ID 1741)

      09:30 - 09:30  |  Author(s): H. Domínguez Malagón

      • Abstract

      Background
      Since IASLC/ATS/ERS reported their new classification for lung adenocarcinoma (ADC), several groups have validated its association with prognosis in early stage. We know do not any study in advanced disease.

      Methods
      We included 313 patients with stage IIIB and IV histologically confirmed lung ADC from the Instituto Nacional de Cancerología (INCan). All patients received platinum-based chemotherapy (CT) and only 30% received EGFR-TKIs. ADCs were re-classified using the new IASLC/ATS/ERS criteria. Clinical characteristics, mutational profile, response and progression-free survival (PFS) to CT and overall survival (OS) were analyzed.

      Results
      ADCs were classified as lepidic 6.1%, acinar 36.7%, papillary 8.3%, micropapillary 2.9%, solid 28.1% and 17.9% were unclassifiable. We divided them into two groups: intermediate-grade (lepidic and acinar-predominant) and high-grade (micropapillary, papillar and solid-predominant). The response rate and PFS to CT were better in the high grade group (36.9% vs 25.4% p= 0.034; 6.4 vs 5.5 months p= 0.009, respectively). The OS was better in the high grade group (25 vs 16.8 p= 0.023). In multivariate analysis, factors associated with better OS were ECOG of 0-1, EGFR mutations and high grade group histology. We did not find association between EGFR mutations and this classification.

      Conclusion
      Unlike early stages, patients with advance disease and with high-grade ADC according to the new classification have longer OS compared with intermediate grade ADC, probably due to a better response to CT.