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: 2
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11981

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    P2.24-035 - Description of lung cancer patients with ECOG 2 at diagnosis. Experience of our Hospital (ID 2448)

    09:30 - 09:30  |  Author(s): J. Hernando
    • Abstract

    Background
    Patients with advanced lung cancer presenting with ECOG 2 at diagnosis trend to be no longer included in large, randomized, registration trials and then recommendations for their treatment are more difficult. Nonetheless, they account for a significant percentage of the cases attended in a Medical Oncology Department. We describe their characteristics and outcomes in our experience.

    Methods
    Medical records of lung cancer patients with ECOG 2 that were seen in our Department between april 2009 and april 2013 have been reviewed.

    Results
    124 patients (p) were found. They account for a 15.3% of the overall number of lung cancer patients attended. 106p were male (85.5%). Median age 66 years (44-83). By histology: adenocarcinoma 41p (33.1%), EGFR+ adenocarcinoma 4p (3.2%), squamous 36p (29.0%), small-cell 23p (18.5%), other 19p (15.3%), no histologic diagnosis 1p (0.8%). By stage: III 39p (31.5%), IV 85 (68.5%). By the time of analysis, 76p (61.3%) hade died, other 31p (25.0%) continued palliative care and 17 (13.7%) were still on active therapy. Initial intention of therapy was palliative in 94p (75.8%), radical/adjuvant in 9 /.3%) and 21p did not receive any active therapy beyond supportive care. Drugs administered at first line: carboplatin 43p (34.7%), cisplatin 12p (9.7%), EGFR-TKI 6p (4.8%), non-platinium chemotherapy 39p (31.5%), no Chemotherpy 24 (19.4%). No differences by gender existed in the drugs given, except for TKI which were more frequently given to women (5/6). Median overall survival was 34 weeks (IC: 26.0-41.9). No differences existed by gender (male 32 weeks, female 39 weeks) or stage (III 30 weeks, IV 36 weeks) but they differed by histology: adenocarcinoma 34 weeks, squamous 22 weeks, EGFR+ aenocarcinoma Not Reached, small cell 59 weeks.

    Conclusion
    A significant percentage of lung cancer patients are diagnosed with ECOG 2 performance status in every histological subtype. Minor differences existed with respect to clinical characteristicas and they benefit from receiving active therapy. This advantage seemed to be lesser in squanous carcinoma.

  • 11982

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    P2.24-036 - Erlotinib in metastatic, EGFR wild-type, Non-Small Cell Lung Cancer (NSCLC) as second or further line of therapy. (ID 3127)

    09:30 - 09:30  |  Author(s): J. Hernando
    • Abstract

    Background
    Erlotinib (E) is a EGF-receptor tyrosine kinase inhibitor (TKI) approved for the treatment of NSCLC after progression to first-line chemotherapy irrespective of EGFR status. Currently EGFR mutation is usually performed upfront upon diagnosis and most mutated patients are treated with first-line TKI's. Nowadays, patients candidates for second line therapies are EGFR-wild-type.

    Methods
    Medical records of EGFR-wild-type patients treated with E in second or further linesbetween March/2008 and March/2013 were reviewed.

    Results
    85 patients (p) were found. Characteristics: Median age 61 years (38-83), 76.5% were male. Tobacco: 42.4% were smokers and 45.9% former smokers. PS 0, 16p; 1, 50p; 2, 19p; by stage: IIIb 27p, IV 58 p. Histology: adenocarcinoma 48p, squamous-cell 25p, undifferentiated or non-specified 11p, adenosquamous 1p. E was given: 40% as second, 44.7% as third and 15.3% as fourth or subsequent line. Effectivity: Partial response 9.4%, Stable disease 48.2%, Progressive disease 41.2%, Not assessable 1%. Overall Survival (OS): median 22 weeks (w) (95% CI, 17.4-26 .7), progression free survival (PFS) 12w (95% CI ,9.8-14 .2). In smokers PFS was 12w also. In squamous carcinomas 10w. In males 11w (these differences were non significant). Toxicity: 92.9%p presented some side-effect: 70.5% rash (49p, G1; 11p, G2); diarrhea 34.1%p (25p, G1; 3p, G2; 1p, G3); asthenia 29.4%p (12p, G1; 6p, G2; 7p, G3); ocular 2.4%p (2p, G1) and digestive 9.5% (2p, G1; 1p, G2; 1p, G3). Dose was reduced in 12.9%p (7p 100 and 4p 125 mg/day). Treatment was interrupted in 7.1%p (median 14 days (range 7-23)); most common causes were G3 skin rash and diarrhea.

    Conclusion
    We described the efficacy of Erlotinib in day-to-day clinical practice when was given beyond the first-line treatment in advanced and metastatic NSCLC without EGFR mutation. Our results are in accordance with has been reported from clinical trials and may reflect its efficacy in clinical practice.