Author of

• 11946

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  P2.24 - Poster Session 2 - Supportive Care (ID 157)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11976

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    P2.24-030 - Increasing Therapeutic Efficacy and Safety of Docetaxel in Lung Cancer (ID 2067)

    09:30 - 09:30  |  Author(s): R. Dhar
    • Abstract

    Background
    Docetaxel is an accepted second line drug for NSCLC not used frequently for its side effects. VT-122 (propranolol and etodolac) which has anti-angiogenic COX-2 inhibition properties. Modifying the tumor-microenvironment and sympathetic system has anticancer activity as well as ameliorates toxicity of anticancer drugs. Docetaxel efficiency can be improved with VT-122 which possesses the above property. To increase efficacy of docetaxel and safety profile using VT-122.

    Methods
    20 (10 in each arm) patients (55-65 years) were treated with docetaxel (75mg/m[2]) with or without VT-122. VT-122 was started 7 days before giving docetaxel. Propranolol doses were titrated to maintaining heart rate around 60. Etodolac was titrated on the basis of CRP to a maximum of 1200mg.

    Results
    Overall Response seen in 4 patients (VT-122 arm) and 2 patients (docetaxel arm). 6 patients in VT-122 arm completed 6 cycles of docetaxel while in non-VT-122 4 patients completed the 6 cycles. 1 year survival was 30% vs 10%; p=0.025. Grade III/IV hematologic toxicity was decreased by 50% ie 6 cases in docetaxel arm and 3 in VT-122. In non-hematological toxicity this trend was seen for asthenia, neuropathy, skin and nail changes and weight loss.

    Conclusion
    Addition of VT-122 (propranolol and etodolac) increases efficacy of docetaxel and is cost effective.

• 12409

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  P3.03 - Poster Session 3 - Technology and Novel Development (ID 152)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Biology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12411

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    P3.03-002 - Heterogenity of Adeno carcinoma of Lung - change in Immunohistochemistry and histopathology chacter in patients treated with chemotherapy or EGFR-TKIs (ID 1356)

    09:30 - 09:30  |  Author(s): R. Dhar
    • Abstract

    Background
    Adenocarcinoma of the lung is a heterogenous group of disease. Even within the same patient, the tumor may show, various patterns of histopathology. In fact published data suggest that only 1/3rd of lung cancer are homogenous. Although known this factor is not taken into account in treatment planning and management. It is also known that treatment induces heterogenity and change in character of the tumor.

    Methods
    46 patients of Stage IV Adenocarcinoma of Lung were studied. All patients were confirmed as Adenocarcinoma by doing IHC TTF p63. All slides were viewed by two pathologists and all patients had EGFR mutation done.IHC marker for neuro-endocrine differentiation was done i.e. Chromogranin-A and Synaptophysin. Patients were treated with chemotherapy or EGFR-TKI. Patients were re-biopsied on progression. The same set of IHC studies was done.

    Results
    

    	IHC marker for adenocarcinoma	IHC marker for squamous cell	Neuro-endocrine marker
    n=46
    Pre-chemotherapy/TKI	41 (89%)	15 (32%)	17 (37%)
    Post-chemotherapy/TKI	25 (54%)	25 (54%)	29 (63%)
    n=18
    Pre TKI	16 (89%)	5 (28%)	4 (22%)
    Post TKI	8 (44%)	9 (50%)	14 (78%)
    n=28
    Pre-chemotherapy	25 (89%)	10 (36%)	13 (46%)
    Post-chemotherapy	17 (61%)	16 (57%)	15 (54%)

    Median duration of chemotherapy - 10 months Median duration of TKI - 16 months Change in character on IHC - seen in approximately 30% patients Infact change in post TKI occurring in upto 50% of patients with gain in Small Cell characters. Of the 50% patients who gained i.e. 10 patients - 7 of them also showed microscopic features of Small Cell Carcinoma of Lungs.

    Conclusion
    The study suggests that patients with advanced lung cancer have benefit from chemotherapy and TKI. On treatment and on progression there is a change in IHC and histopathology character in the patients. It occurs in close to 40% in such patients. These changes also call for changes in treatment. Hence re-biopy in such patients is essential.