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E.O. Macedo
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ORAL 30 - Community Practice (ID 141)
- Event: WCLC 2015
- Type: Oral Session
- Track: Community Practice
- Presentations: 1
- Moderators:P.S.S. Kho, R. Jotte
- Coordinates: 9/08/2015, 16:45 - 18:15, Mile High Ballroom 2c-3c
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ORAL30.07 - Different Mutation Profiles and Clinical Characteristics Among Hispanic Patients with NSCLC Could Explain The 'Hispanic Paradox' (ID 748)
17:50 - 18:01 | Author(s): E.O. Macedo
- Abstract
- Presentation
Background:
Sixteen percent of the U.S. population is Hispanic, predominantly of Mexican ancestry. Recently, two independent American reports demonstrated a higher overall survival (OS) in Hispanic populations compared with non-Hispanic-white populations (NHW) in patients with non-small-cell lung cancer (NSCLC) diagnosis. The latter even when most of the Hispanics are diagnosed at advanced stages of disease and are low-income patients. The aim of our study was to analyze the clinical, pathological, and molecular characteristics as well as the outcomes in a cohort of NSCLC Hispanic patients from the National Cancer Institute of Mexico that could explain this "Hispanic Paradox".
Methods:
A cohort of 1260 consecutive NSCLC patients treated at the National Cancer Institute of Mexico from 2007-2014 was analyzed. Their clinical- pathological characteristics, the mutation-status of EGFR and KRAS and the prognosis were evaluated.
Results:
Patients presented with stages of disease: II (0.6%), IIIa (4.8%), IIIb (18.4%) and IV (76.3%). NSCLC was associated with smoking in 56.5% of the patients (76.7% of male vs. 33.0% of female patients). Wood smoke exposure (WSE) was associated with 37.2% of the cases (27.3% in men vs. 48.8% in women). The frequency of EGFR mutations was 28.1% (18.5% in males vs. 36.9% in females, p<0.001) and the frequency for KRAS mutations was 10.2% (10.3% men vs. 10.1% in women p= 0.939). The median OS for all patients was 23.0 months [CI95% 19.4-26.2], whereas for patients at stage IV, it was 20.1 months [CI 95% 16.5-23.7]. The independent factors associated with the OS were as follows, the ECOG Performance Status, stage of disease, EGFR and KRAS mutation status.
Conclusion:
The high frequency of EGFR mutations and low frequency of KRAS mutations in Hispanic populations and different prevalence in lung cancer-related-developing risk factors compared with Caucasian populations, such as the lower frequency of smoking exposure and higher WSE, particularly in women, might explain the prognosis differences between foreign-born-Hispanics, US-born-Hispanics and NHWs.
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P3.06 - Poster Session/ Screening and Early Detection (ID 220)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.06-026 - Gene Expression Signature to Predict Early Development of Brain Metastasis in Lung Adenocarcinoma (ID 1273)
09:30 - 09:30 | Author(s): E.O. Macedo
- Abstract
Background:
Advances in systemic treatment have substantially improved the overall survival of advanced lung adenocarcinoma patients, and risk of brain metastases(BM) is higher. The survival of patients with symptomatic BM is poor. The identification of NSCLC patients with a high risk of developing BM would enable pre-emptive intervention to improve the outcome.
Methods:
A total of 53 biopsies of primary lung tumor adenocarcinoma stage IV treatment-naïve were analyzed for gene expression profiling using Affymetrix HuGene 1.0 ST and were processed in R using Bioconductor libraries. All patients were evaluated with brain MRI at diagnosis with a 3-month follow-up for BM development. Patients were classified into two groups: early-BM( < 6 months) and late-BM( > 6 months). A second independent cohort of 55 patients was analyzed to validate the gene expression signature (ClinicalTrials.gov: NCT00862173).
Results:
Samples were classified as early-BM(17) and late-BM(6), the remainder 30 never developed BM. Significant changes in gene expression of about100 genes were found. Eleven highly significant genes (B-stat > 12) were associated with process of cell-migrationCNN3(down-reg.) and adhesionCDH10(up-reg); anti-apoptosisBAG1(up-reg); immunological evasionSSX2(up-reg) and RAET1E(up-reg); signaling pathways related to RAS gene RAB9A(up-reg) and RAPGEF5(down-reg); mRNA-tRNA translocationDUS2L(up-reg); methylation controlNOC2L(up-reg); and members of the EGFR family EPGN(up-reg) and IGFR, IGF2BP1(up-reg).
Conclusion:
We describe an 11-gene signature that may predict the risk of BM which has the potential to classify patients and evaluate screening strategies that would facilitate pre-emptive interventional trials such as prophylactic cranial irradiation.
