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S. Rahatli
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P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.03-014 - Correlation of Response and Prognostic Markers with Survival in Locally Advanced NSCLC Patients Who Have Treated with Neoadjuvant Chemotherapy (ID 1141)
09:30 - 09:30 | Author(s): S. Rahatli
- Abstract
Background:
Lung cancer is the most common cause of death from cancer... NSCLC constitutes 80-85% of all lung cancers. One third of NSCLC is diagnosed at locally advanced. Stage III involves heterogeneous group of patients. Therefore, it is the group of patients with most controversial for treatment. Currently there is no standardized approach to definitive treatment. In this study, we aimed to determine the response to neoadjuvant chemotherapy in patients with stage III NSCLC who had received neoadjuvant therapy. We also aimed to determine the relationship with prognosis and treatment response of the expression of ERCC1 and RRM1.
Methods:
27 pts with stage III NSCLC were included in this study who received neoadjuvant chemotherapy at the Dept of M. Oncology and had been operated by the at Baskent University 2003 and 2013. Lung tissue biopsies were evaluated by IHC methods for ERCC1 protein expression in patients who received neoadjuvant cisplatin and for RRM1 protein expression in patients who received neoadjuvant gemcitabine. OS and DFS durations were calculated for patients who received neoadjuvant chemotherapy. In addition, the relationship between pathological response and survival of the expression of ERCC1 and of RRM1 were evaluated.
Results:
One (3.7%) women and 26 (96.3%) male pts were enrolled in the study. Median age 59. 14 (51.9%) underwent lobectomy and 13 pts (48.1%) were performed pneumonectomy. According to the TNM staging system; 19 pts (70.4%) were at stage 3A and eight pts (29.6 %) were at stage 3B. All of the patients received neoadjuvant cisplatin-based chemotherapy. 15 patients (55.6%) were identified of relapse during follow-up. The median f/u was 36 mos. In follow-up, 14 pts have died. The average DFS was 26.6 months. The average OS was 48 mos. From the perspective of stage 3A and 3B; DFS (p = 0.379) and OS (p = 0.69) did not differ significantly in terms. 16 pts (59.3%) after receiving neoadjuvant chemotherapy was found viable tumor ratio equal and under 10% in the surgical pathology materials. 11 pts (40%) was found viable tumor above the rate of 10% . When considered from this point of view DFS and OS showed no difference. More patients survived in the group with low ERCC1 expression. Between pts with low ERCC1 expression and pts with high ERCC1 expression showed no difference in terms of survival . (both DFS and OS). Pts with high RRM1 expression showing resistance to gemcitabine and with low RRM1 expression had similar survival rates.
Conclusion:
In patients with stage III NSCLC who received neoadjuvant chemotherapy found longer OS and DFS durations than from literature. Published studies and the results of our study albeit small scale, suggests that in the near future especially for patients with stage IIIA and stage IIIB NSCLC will be suitable for neoadjuvant chemotherapy as standard approach applied. ERCC1 and RRM1 expressions that were predictive markers of response of the treatment for cisplatin and gemcitabine was not correlated to therapy and survival . This may be associated with less number of and is a lack of full-refractory patient population.
