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D. Vassos



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    P1.10 - Poster Session 1 - Chemotherapy (ID 204)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.10-005 - Bevacizumab (Bv) can be safely administered in pts aged > 80 years old (ID 303)

      09:30 - 09:30  |  Author(s): D. Vassos

      • Abstract

      Background
      Bv is a novel anti-angiogenic agent used in many advanced solid tumours, including non-squamous NSCLC. In contrast to clinical studies where enrolled pts are fit, many elderly NSCLC pts suffer from co-morbidities and often have history of a CVD

      Methods
      Medical records of 2672 pts diagnosed with NSCLC between 2001-2012 were screened. We identified and examined pts ≥75 yrs old treated with bev, for their demographics, clinical data and treatment (Tx) details. We focused on those elderly pts with stable pre-existing cardiovascular disease.

      Results
      356/2672 NSCLC pts received Bv at any Tx line. 33/382 (8,6%) were ≥75 yrs old. Of those, 29 had various co-morbidities including 19 pts with stable CVD on medical Tx. In the 19 pts with CVD the male:female ratio was 17:2 and mean age 77 yrs (range 75-86). 8/19 pts had impaired renal function. All pts were of Performance Status ECOG 0/1. Median number of Bv cycles was 5 (range 2-11). 17/19 pts experienced ≥1 side effects (11 epistaxis and haemoptysis, 5 proteinuria, 4 hypertension) which led to treatment discontinuation in 5 pts. No major/fatal adverse events were noted. 8/19 pts (42%) showed radiological partial response and 5 (19%) stable disease (total disease control rate 61%). Median survival from initiation of Bv till death/last follow up was 7 months (range 2-28, 95% CI 5.14-12.55).

      Conclusion
      Treatment with Bevacizumab seems to be safe and effective in elderly NSCLC patients with controlled pre-existing cardiovascular disease and good PS. These patients might benefit from participation in clinical trials similarly to younger NSCLC patients.

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

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.10-005 - Erlotinib (E) can be safely administered in pts > 80 years old (ID 345)

      09:30 - 09:30  |  Author(s): D. Vassos

      • Abstract

      Background
      Besides chemotherapy, E is another option in NSCLC pts especially in those with EGFR mutations. Elderly pts enrolled in trials are fit without cM, but in clinical practice most suffer from cM.

      Methods
      Medical records of 1221 pts diagnosed with NSCLC between 2008-2012 were screened. We examined pts ≥75 yrs for demographics, clinical data and Tx details.

      Results
      233/1221 NSCLC pts received E at any line. 53/233 (23%) were ≥75 yrs old. Male:female ratio was 34:19 and median age 79 yrs (range 75-88). NSCLC subtypes included 31 adenoca, 8 squamous cell, 9 NOS and 5 others. 50/53 pts had cM (≥2 in 46 pts, 1 in 4pt). Main cM were cardiovascular disease (n=41), COPD (n=14), other cancer (n=10) and diabetes (n=8). 8 pts were tested for EGFR mutations (5 -ve, 3 +ve). Performance Status was satisfactory (ECOG 0-1) in 8 pts and poor (2-3) in 45pts. 8pts were treated with E 100mg and 45 pts with E 150mg (12 pts needed dose reduction). Complete follow up data were found in 46pts. Mean duration of treatment was 79 days (range 9-662). 35/46 pts experienced side effects (s.e) [rash n=29, diarrhea n=17] which led to treatment discontinuation in 12pts. Pts with abnormal creatinine clearance (n=13) were more likely to stop treatment due to s.e (6/13 versus 6/33). 17/46 pts (37%) achieved disease control (5 PR, 12 SD) and a time to progression (TTP) of 157 days (range 106-662, 95% CI 132.79-270,74) while 22/46 pts had PD as best response (TTP 49d, range 19-88, CI 44,67-64,97). 7pts were not evaluable (stopped Tx due to s.e). All EGFR+ve pts had disease control (2PR, 1SD).

      Conclusion
      E is a valuable option in elderly NSCLC patients with co-morbidities, especially if they harbor EGFR mutations. Impaired renal function might be associated with propensity to side effects and earlyTx discontinuation.

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    P2.13 - Poster Session 2 - SCLC (ID 201)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.13-005 - Palonosetron (Aloxi®) effectively prevents nausea and emesis in SCLC patients receiving platinum-based three days regimen. (ID 2179)

      09:30 - 09:30  |  Author(s): D. Vassos

      • Abstract

      Background
      We evaluated retrospectively the safety and effectiveness of single dose administration of palonosetron (Aloxi®) in SCLC patients receiving platinum-based three days regimen.

      Methods
      We retrospectively recorded the nausea and emesis of 417 SCLC patients (337 men and 80 women) with mean age 69.1 years (SD=9.0 years). Of those 63.3% had Extensive Disease (ED) and 36.7% Limited Disaese (LD). 318 pts (76.3%) received six cycles of chemotherapy and 229 pts (67%) received also radiotherapy, either concurrent or sequential. With regard to the chemotherapy regimen, 290 pts (69.5%) received Carboplatin (D1) & etoposide (D1-3), 99 pts (23.7%) received Carboplatin (D1), Irinotecan (D1) & etoposide(D1-3), and 28 pt (6.7%) received Cicplatin (D1) and etoposide (D1-3). The antiemetic treatment was i.v. administration of 0.25mg palonosetron on D1.

      Results
      315 (75.5%) of 417 patients didn’t experience any acute nausea and 329 (78.9%) patients remained free of nausea in the delayed phase . Free of vomit was 380 (91%) patients in the acute phase and 390 (93.5%) in the delayed phase. In compination 314 (75.3%) patients was free of vomit or nausea in the acute phase and 326 (78.2%) in the delayed phase with the use of palonosetron. No signs or symptoms due to toxicity from palonosetron observed in acute or delayed phase . Both univariate and multiple analyses indicated that the odds of nausea decreases as age increases and that woman had greater odds for nausea. No smoking related differences were recorded, but 94.8% of the patients were smoker. Addition of radiotherapy did not increase the probability of nausea or emesis and patients receiving cisplatin instead of carboplatin were more likely to experience nausea or emesis.

      Conclusion
      Our data indicate that single dose of palonosetron on D1 effectively controls acute and delayed nausea and emesis in SCLC patients receiving platinum based three days regimen.