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E. Casado
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P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.04-032 - Clinical and Pathological Characterization of Long-Term Survivors with Advanced Non-Small Cell Lung Cancer: A Multicenter Experience in Madrid (ID 378)
09:30 - 09:30 | Author(s): E. Casado
- Abstract
Background:
Long-time survival is an important goal in NSCLC treatment. However, in patients (pts) with wild type EGFR and non translocated ALK (EGFRwt/ALKnt) advanced disease, median survival at diagnosis is around 9-14 months and long time survivors (LTS) constitute a very small proportion of these patients. The aim of our research was to explore the clinical-pathological characteristics of a population of EGFRwt/ALKnt LTS with an overall survival (OS) of at least 36 months, with the purpose to identify which clinical-pathological features could help to identify a better outcome in advanced NSCLC.
Methods:
We analyzed retrospectively data from patients diagnosed of EGFRwt/ALKnt advanced NSCLC with an OS of at least 36 months and treated in 8 institutions from Madrid (Spain). All these patients were selected in a period of 10 years (January 2002 to 2012). We analyzed clinical-pathological characteristics (age, sex, ECOG, stage IIIB vs IV, histology, smoking status, diabetes and vascular disease, weight loss >10%, symptoms at diagnosis and sites of metastasis), laboratory parameters (LDH and haemoglobin levels) and type of treatment administered (platinum based treatment, metasectomies, number of chemotherapy lines, maintenance, grade 4 toxicity as well as metformine intake). Finally, data from PFS and OS were also collected.
Results:
Among all patients diagnosed with EGFRwt/ALKnt NSCLC and treated in 8 institutions in 10 years, we identified 93 pts with an OS of at least 36 months. 55 pts (60%) were older 65 years, 67 pts (71%) male and 85 pts (91 %) were smokers/former smokers. Comorbidities (diabetes and vascular disease) were infrequent: 7pts (7%) and 13 pts (14%), respectively. Adenocarcinoma was most common pathological subgroup (60 pts, 65%) followed by squamous (21 pts, 22%), large cell carcinoma (7, 7%) and “other histologies” (6 pts, 6%). The majority of them, had a good PS; ECOG 0 32 pts (34%) and 1 57 pts (61%). A minority of patients had weight loss greater than 10% at presentation (12 pts, 14%). Most frequent symptoms were cough (41 pts, 44%), followed by pain (34 pts, 36%), dyspnea (25 pts, 27%) and haemoptysis (9 pts, 9%). LDH and haemoglobin leves were normal in the majority (65 pts, 70% and 72 pts, 77%, respectively). On the other hand, metformin intake was uncommon (16 pts, 17%). One or two metastatic sites at diagnosis were described in 44 pts, 47% and 29 pts, 31%, respectively and only 13 pts (14%) had brain metastasis (mts) and 5 (5%) adrenal mts. First-line chemotherapy based in platinum was administrated in 92 pts (98%), however, maintenance therapy only in 41 pts (44%). Local treatment (metasectomies +/-RT), was done in 35 pts (38 %). Grade 4 toxicity was detected in 7 pts (7%). Finally, we estimated a median PFS of 13.4 months and median OS of 40.5 months
Conclusion:
To our knowledge, this is the largest multicenter serie reported of very long-term survivors (OS >36 months) with with EGFRwt/ALKnt advanced NSCLC. This study includes an exhaustive clinical and pathological analysis of this specific population. In this moment, we are carrying out a comprehensive molecular analysis
