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M. Gumus



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    P1.22 - Poster Session 1 - Epidemiology, Etiology (ID 166)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      P1.22-002 - Non-small cell lung cancer in young patients: Clinicopathological features (ID 670)

      09:30 - 09:30  |  Author(s): M. Gumus

      • Abstract

      Background
      Non-small cell lung cancer (NSCLC) is the most common cancer worldwide. NSCLC is strongly related to age. Its incidence increases with advancing age and the median age at diagnosis is 70 years. Less than 5% of all NSCLC is seen before 40 years of age. Furthermore, young patients have different characteristics compared with older patients. In this study, the clinical features of patients less than 40 years of age were analyzed.

      Methods
      Medical records of patients diagnosed as having NSCLC between March 2000 and March 2013 were retrospectively examined in 17 institutions of Anatolian Society of Medical Oncology. Epidemiological data such as age, gender and smoking history was collected. Additionally, histological subtype, ECOG performance status, stage, number of organ metastasis, presence of cranial metastases were analyzed.

      Results
      A total of 210 patients were evaluated. Median age was 35 years (range, 18-40). The majority of the patients were males (148 males and 62 females). There were 120 patients with a history of smoking. Seventy-eight patients were non-smokers and twelve were unknown. Majority of the patients (64%) had stage IV disease at presentation. Most of the patients had good performance status. Half of these patients had two or more organ metastasis (53%). Cranial metastases were detected in 55 patients. Adenocarcinoma was the most common histological subtype (57%). Other subtypes were squamous cell carcinoma (20%) and unclassified (20%). In stage IV disease, adenocarcinoma was more frequent (64%). There was no association between histopathologic subtype and smoking history. Median overall survival (OS) of the entire cohort was 15.1 months. Median OS was similar to the literature data (stage II: 45.8 months, IIIA: 44.4 months, IIIB: 21.1 months and stage IV: 9.9 months).

      Conclusion
      Adenocarcinoma was more common in the younger patients. These patients had advanced disease and good performance status at presentation. However, survival was not better than older patients based on historical literature data.

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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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      P2.10-034 - Is Second Line Systemic Chemotherapy Beneficial in Patients with Non-Small Cell Lung Cancer (NSCLC)? : A Multicenter Data Evaluation of Anatolian Society of Medical Oncology (ASMO) (ID 2389)

      09:30 - 09:30  |  Author(s): M. Gumus

      • Abstract

      Background
      Although NSCLC patients have a very poor prognosis, they generally need a second line therapy. Studies have shown that both systemic chemotherapy and targeted therapies are useful in this setting. To determine the patients who would get benefit from second line therapy may increase the success rate of the treatment. In this multicenter study, we aimed to evaluate the parameters that determine the benefit of second line treatment in NSCLC.

      Methods
      Records of NSCLC patients who received second line systemic therapy in 11 centers from Turkey were evaluated retrospectively. Age, gender, histological subtype, stage at diagnosis, performance status, serum hemoglobin level, serum lactate dehydrogenase level, response to first line therapy, platinum sensitivity, and progression free survival after first line therapy were investigated whether they have any role in detecting the usefulness of second line therapy. Additionally, PFS and OS after second line therapy were analyzed.

      Results
      Overall, the data of 904 patients (31% female and 75% < 65 years old) were evaluated. Median follow up was 13 (2-197) months. The rate of adenocarcinoma, squamous cell carcinoma, and NSCLC-NOS were 47%, 32%, and 23%, respectively. At diagnosis, 22% of patients had stage 3B, and 78% had stage 4 disease. Single agent docetaxel was preferred the most as a second-line therapy (21%). The survival analysis showed that median PFS and median OS were 4 months (SE: 0.2; 95% CI: 3.6-4.3), and 7 months (SE:1: 95% CI: 6-8), respectively. In univariate analysis, performance status, normal hemoglobin level, having stage 3B at diagnosis, response to first line therapy, and PFS of 3 months or longer after first line therapy were found to be significant for overall survival after second line therapy (p values <0.05). In multivariate cox regression analysis, good performance status, normal hemoglobin level, and response to first line therapy were independent prognostic factors for survival (p<0.0001, p<0.0001, and p=0.001, respectively).

      Conclusion
      Our findings revealed that second-line therapy is beneficial in patients who have good performance status and who responded to the first-line therapy. Detecting the parameters that predict the usefulness of second-line therapy may increase the success rate and guide the selection of patients for this therapy.

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    P3.13 - Poster Session 3 - SCLC (ID 202)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P3.13-001 - Could Pretreatment PET-CT Standart Uptake Values Have a Role in the Response to Treatment and the Survival in Patients with Small Cell Lung Cancer? (ID 666)

      09:30 - 09:30  |  Author(s): M. Gumus

      • Abstract

      Background
      It is of great importance for treatment optimization to know before the initiation of treatment the different variables that may be used to help determine the result in the oncological diseases. It has been shown in preveious studies that have been performed that standard uptake values obtained in PET-CT carried out before the treatment in various cancer types enable us to make predictions regarding the tumor’s “aggressiveness”, response to treatment and survival. In this study, we researched the predictive role of pretreatment SU values of the patients with SCLC in determining the response to treatment and the survival.

      Methods
      Ninty patients were enrolled into this study, with whom we had follow-up in our center due to SCLC, and in whom pretreatment PET-CT was performed. The SU value of primary tumor was then determined. The relationship between these values and response to treatment is examined through ROC analysis and the cut-off value, effective and thus the determination to the response to treatment is identified. In the patient group, age, gender, stage, performance status, response to treatment, and effect of SU values upon response to treatment and survival are studied.

      Results
      Ninty patients were enrolled into the study. Median follow-up period is 11 (1-43) months, and the median age is 58 (39-83). Ninety percent of patients are male and the diseases in 37% of were noted to be of limited-stage. All patients received platinum+etoposide chemotherapy once every 21 days, as median amount of treatments to cure was 6 (3-7). When ROC analysis was carried out the SU value, suitable for determining the response, is found to be 10. The sensitivity of this value is found 85.7% (CI 95%; 63-96), the specificity was found to be 61.8% (CI 95%; 49-73) (AUC: 0.783; p: 0.0001). The overall response rate (complet response+partial response) is 59.1% in the other patients, while this rate is 93.3% in patients with involvement above the cut-off value(p:<0.0001). The response rates are higher in patients with age greater than or equal to 60 years old (p:0.047). No significant relationship is found between gender, stage and performance status, and the response to treatment. In the survival analyses carried out, median disease-free survival is found to be 9 months (SE:1; 95% CI: 8-10), and median general survival was determined to be 17 months (SE:3; 95% CI: 12-22). When single and multivariate analysis are carried out, the positive impact/effect of limited-stage disease and response to treatment upon the progression-free survival is determined (p<0.05). The fact that SU value is higher than cut-off value, affects the progression-free survival positively borderline (p:0.085). As a result, this is effective upon general survival, and studied using single and multivariate analysis. It is seen that only the response rates affect the general survival positively (p<0.05).

      Conclusion
      PET-CT is used in SCLC frequently for staging purposes. The data obtained in PET-CT may have a role in determining the prognostic characteristics of the disease as well as the response to treatment.