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P. Berzinec
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P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.01-069 - Reasons for Discontinuation of Treatment with Bevacizumab in Patients with Non-Progressing NSCLC - Retrospective Study (ID 3243)
09:30 - 09:30 | Author(s): P. Berzinec
- Abstract
Background:
In general, bevacizumab is well-tolerated treatment in patients with advanced, metastatic non-squamous NSCLC. Despite this, permanent discontinuations of bevacizumab occur also before progressive disease (PD), both in clinical trials and in clinical practice. Purpose of this study was to find out the reasons for permanent discontinuation of bevacizumab before PD in patients treated in two centers in the Slovak republic.
Methods:
In this retrospective study, approved by the Ethics Committee of the Specialized Hospital of St Zoerardus Zobor, the institutional databases were searched for patients with advanced NSCLC treated with bevacizumab between 2007 and 2013.
Results:
Altogether 161 patients were included into the analysis. Patients' characteristics: M/W: 99/62, age: median 61 years (32 - 83), histologically /cytologically confirmed NSCLC: adenocarcinoma/large cell/adenosquamous: 158/2/1. Number of cycles with bevacizumab (induction and maintenance): median 8 (1 - 52), PFS: median 7 months (1 - 42). Bevacizumab was permanently discontinued before PD in 28 of 161 patients (17,4%), in 18 of 161 (11,2%) due to undesirable effects - Table 1. Table 1: Reasons for permanent discontinuation of bevacizumab in non-progressing NSCLCUndesirable effects N Other reasons N Cavitation 3 Lost to FU 2 Pneumothoraces 3 Molecular testing, start of TKI 2 Cerebrovascular event 2 Patients' preference 2 Gastrointestinal perforation 2 Car accident, death 1 Hypertensive crisis 2 Planned surgery 1 Pneumonia 2 Traumatic fractures 1 Proteinuria 2 Other 1 Thrombotic event 2 All 18 All 10
Conclusion:
Permanent discontinuation of bevacizumab in non-progressing NSCLC was seen in this study in the similar rate as in the larger trials (Wozniak AJ et al. Clin Oncol [Coll Radiol]. 2015, 27:187-96.) However, some differences are in the type of undesirable effects, which are in part also chemotherapy related.
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P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.01-025 - Crizotinib in Advanced ALK-Positive NSCLC - A Retrospective Multicenter Study in the Slovak Republic (ID 3014)
09:30 - 09:30 | Author(s): P. Berzinec
- Abstract
Background:
Crizotinib has been available in Slovakia since October 2012 for the treatment of adults with previously treated ALK-positive advanced non-small cell lung cancer (NSCLC), based on the therapeutic indication approved by the European Medicines Agency. Purpose of this study was to assess the results achieved with crizotinib in the treatment of advanced NSCLC in clinical practice in Slovakia.
Methods:
In this multicenter retrospective study, approved by the Ethical Committee of the Specialized Hospital of St Zoerardus Zobor, the data of 30 ALK-positive patients were reviewed. FISH with break-apart probes was used for the confirmation of ALK rearrangement in all cases. MedCalc[®] was used for the statistical analyses.
Results:
Between October 2012 and August 2014, 20 out of 30 ALK-positive patients were treated with crizotinib. Ten patients did not receive crizotinib: five due to on-going first-line chemotherapy, five due to other reasons. Characteristics of the treated patients: M/W: 6/14, age (years) median 56, range 23-77, PS (ECOG/WHO): 0/1/2/3: 1/10/4/5, Histology: 19 patients adenocarcinoma, 1 NSCLC, NOS. Treatment results: RR was evaluated in 20 patients: PR + CR: 13 (12+1), 65% (95% CI: 41-85), SD: 3, 15% (95% CI: 3-38), PD: 3, 15% (95% CI: 3-38), NS: 1, 5%, DCR: 16, 80% (95% CI: 56-94), PFS: Kaplan-Meier estimate: 13 months (95% CI: 7 -18), 0S (with 60% of patients censored): 19 months (95%CI: 12 - NR), PS: significant improvement within 2 months (mean dif. –0.95, P=0.0021), toxicities grade 3/4 occurred in 11 of 20 patients (55%), hematologic: 0, non-hematologic: hepatotoxicity 3/1, pneumonitis: 1/0, diarrhea 1/0, nausea: 3/0, vomiting: 1/1, vision disorder: 1/0, peripheral edema: 1/0, QT-interval prolongation: 1/0. Crizotinib was permanently discontinued due to toxicity in only two patients.
Conclusion:
Treatment results seen in this retrospective study are encouraging and consistent with the published data from the prospective trials.
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P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.04-045 - Insights into NSCLC Molecular Testing in Central and Eastern European Countries (ID 2615)
09:30 - 09:30 | Author(s): P. Berzinec
- Abstract
Background:
Information is lacking about molecular testing practices for NSCLC in Central and Eastern Europe; identification of the challenges for personalized lung cancer treatment within this region might facilitate strategies to overcome these and to improve patient care.
Methods:
A Working Group of oncologists, pulmonologists and pathologists from Central and Eastern Europe was established in order to get more information about NSCLC molecular testing used in these countries, technologies, patient selection, availability and other questions, and to raise greater awareness of the current issues around personalized medicine for lung cancer in this region. As a first step, a questionnaire including 37 questions about issues connected with NSCLC molecular testing and other aspects of NSCLC management was distributed in 2014 to 59 specialists in different areas of NSCLC, including epidemiologists, oncologists, pulmonologists and pathologists.
Results:
In all, 25 experts from 9 countries (Bulgaria, Croatia, Czech Republic, Hungary, Israel, Poland, Slovakia, Slovenia, Turkey) responded. The responses show that there are some differences between the countries in the region and also between centers within countries with regard to NSCLC molecular testing. Some are minor, e.g. for EGFR mutation testing real-time PCR is used in all countries, direct sequencing in 5, and other methods are used in addition in only 2 countries. Up to one-quarter of samples are inadequate for testing. For ALK testing, IHC followed by FISH and/or FISH alone are currently used in all 7 countries with responses; in Israel, other methods including DNA sequencing are also used. However, some of the differences are quite large, such as the proportion of eligible patients tested for EGFR mutations and ALK rearrangements, and the proportion of NSCLC patients discussed at multidisciplinary tumor boards. There is also wide variation in funding sources for EGFR and ALK testing.
Conclusion:
NSCLC molecular testing is available in all Central and Eastern European countries participating in this survey. For the future, ensuring adequate NSCLC samples, solving sustainable financing of molecular testing and enabling wide access of eligible patients to molecular testing resulting in raising the number of patients reviewed by multidisciplinary boards are among the key challenges.
