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J. Morere
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P1.06 - Poster Session/ Screening and Early Detection (ID 218)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.06-004 - Common Misconceptions About Lung Cancer Screening: A Nationwide Survey (ID 1755)
09:30 - 09:30 | Author(s): J. Morere
- Abstract
Background:
The National Lung Cancer Screening Trial has demonstrated the efficacy of lung cancer screening based on annual low-dose computed tomography (CT) scanning in both former and current smokers. Nationwide lung cancer screening programs are therefore expected to be implemented. Adhesion to these programs will depend largely on public information regarding lung cancer screening. Here, we report on widespread beliefs regarding lung cancer screening in the general population prior to any information campaigns on lung cancer screening.
Methods:
The EDIFICE French nationwide observational surveys, conducted every 3 years since 2005, set out to characterize behaviors related to cancer screening. The 4th edition, EDIFICE 4, was conducted by phone interviews of a representative sample of 1602 subjects aged between 40 and 75 years, using the quota method, from June 12 to July 10, 2014. Attitudes and opinions regarding colorectal, prostate, breast, cervical and lung cancer screening were assessed.
Results:
For 43% of the French population, lung cancer screening is more reassuring than distressing. This figure is lower than those reported for perceptions of other screening programs, including colorectal cancer screening (51%) and breast cancer screening (63% vs. 46.7% for lung cancer screening in the female population). Eleven percent of the respondents (N=162) declared having already undergone a lung cancer screening test. For the vast majority (87%, N=140), this comprised a chest X-ray and for 63%, (N=101) the chest X-ray was not associated with another type of examination. Respondent-declared reasons for not undergoing screening included absence of risk factors (36%), absence of respiratory symptoms (34%), absence of physician recommendations for screening (29%) and futility (11%). Seven percent of current smokers and 32% of former smokers did not undergo screening because they did not consider themselves at risk for lung cancer. Fear of the results pushed 9% of current smokers to avoid lung cancer screening. However, 22% of all respondents and 38% of current smokers declared their intention to undergo a lung cancer screening test in the future.
Conclusion:
The general population has many misconceptions of lung cancer screening. Implementation of nationwide lung cancer screening programs should include information for the general public regarding selection criteria, techniques used and the benefits of lung cancer screening using low-dose CT scanning.
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P2.05 - Poster Session/ Prevention and Tobacco Control (ID 216)
- Event: WCLC 2015
- Type: Poster
- Track: Prevention and Tobacco Control
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.05-009 - Tobacco Addiction and Perception of Risk of Lung Cancer in Vulnerable Populations (ID 1415)
09:30 - 09:30 | Author(s): J. Morere
- Abstract
Background:
Social indicators of vulnerable populations are associated with increased rates of comorbidities and risk factors for cancer but not with screening attendance, as previously shown by the French EDIFICE surveys. The present work sought to determine whether living in poor economic social conditions is associated with specific behavior or beliefs that increase exposure to the risk factors for lung cancer.
Methods:
The 4th French nationwide observational survey, EDIFICE 4, was conducted by phone from June 12 to July 10, 2014 among a representative sample of 1602 individuals aged between 40 and 75 years, using the quota method. Individuals were questioned about their smoking habits. Tobacco addiction was evaluated in current smokers using the Fagerström Test for Cigarette Dependence (FTCD) score, which ranks participants into one of four groups: no dependence, low, moderate, and high dependence. Risk perception compared to the average-risk population was self-assessed. Data were analyzed according to the validated EPICES vulnerability score.
Results:
Vulnerable individuals (N=455) were more frequently current smokers than non-vulnerable individuals (N=941) (34.1% vs 19.9%; P≤0.01) and less frequently former smokers (25.9% vs. 35.8%; P≤0.01). Compared to the non-vulnerable population, current and former cigarette smokers in the vulnerable population were more likely to have started smoking before the age of 15 (33.8% vs. 25.5%, P≤0.05), and had a higher average consumption (16.6 pack-years [SD 16.25] vs. 13.59 pack-years [SD 16.44]; P≤0.01). Vulnerable individuals were also more likely to stop smoking for periods of less than 1 year or for 1-9 years (18.6% vs. 10.4% and 29.2% vs. 19.4%, respectively; P≤0.05) but were less likely to quit for longer periods (10-19 years, 17.6% vs. 27.1%, P≤0.05; 20-29 years, 17.2% vs. 22.5% and ≥30 years, 17.5% vs. 20.3%, not statistically different). Likewise, vulnerable individuals had higher average FTCD scores (3.24 [SD 2.38] vs. 2.55 [SD 2.16], P≤0.01) and were more frequently ranked as moderately or highly dependent on cigarettes (32.0% vs. 21.5%, P≤0.05). Respondents were asked about the number of cigarettes per day they considered to be associated with no risk of lung cancer; average replies were 3.01 (SD 5.40) in the vulnerable population vs. 1.93 (SD 3.90, P≤0.01) in the non-vulnerable population. The former were also less likely to spontaneously cite a number of lung cancer risk factors (unhealthy life-style 93.8% vs. 97.5%, active smoking 91.3% vs. 95.5%; passive smoking 60.4% vs. 72.0%; P≤0.01). But they were more likely to rank their own risk of lung cancer as higher than that of the average population (22.6% vs. 16.6%, P≤0.01) and to consider screening as more distressing than reassuring (25.9% vs 18.3%, P≤0.01).
Conclusion:
Because they develop a heavy, long-lasting consumption of tobacco and are less likely to quit smoking permanently, vulnerable individuals are more exposed to the tobacco-consumption-related risks of lung cancer. Paradoxically, they also appeared both less concerned and more anxious about the risks of lung cancer than non-vulnerable populations. These results highlight the urgency of implementing information campaigns, prevention messages, and smoking cessation support specifically targeting this vulnerable population.
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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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P3.04-064 - A 24h-Single Highthroughput Assay to Identify ALK or ROS-1 Gene Fusions and EGFR Mutations in DNA from FFPE Tumor Samples or Free Circulating DNA (ID 2811)
09:30 - 09:30 | Author(s): J. Morere
- Abstract
Background:
The diagnosis of metastatic lung adenocarcinoma to decide tyrosine kinase inhibitors (TKI) targeting either EGFR mutations or ALK or ROS translocations requires the combination of several techniques and different biological or pathological expertises. These are DNA sequence analysis, immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) that are performed independently and require time and DNA materials. Importantly, to our knowledge no diagnostic can be performed on extracted DNA from FFPE tumors for the identification of ALK or ROS translocations except FISH. FISH is considered as the gold standard technique for gene translocations but time-consumable and not applicable to highthoughput diagnosis. Some unsuccessful attempts have been made using RNA extracted from FFPE.
Methods:
We have developed and patented an assay using the i-plex technology and mass spectrometry detection (Sequenom-Agena Bioscience, CA, USA) allowing the concomitant identification of 20 targeted EGFR exon 18-21 gene sequence abnormalities as well as variants of EML4-ALK (variants 1-2-3a-3b) or ROS1-SLC34A2/EZR/CD74 gene fusions on extracted DNA samples in a single 24h experiment. DNA has been extracted eitherfrom either FFPE tumor samples or plasma free circulating DNA.
Results:
DNA samples from 6 different patient can be analyzed on the same 96 wells-assay (more if a 384 well-assay). As low as 16ng DNA per sample from FFPE biopsies (10 slices) or plama can be used. We have applied this new panel to a cohort of 90 lung adenocarcinoma samples positive for EGFR mutations (n=30), ALK (n=30) or ROS (n=30) translocations; one third being extracted DNA from circulating plasma samples. The limit of detection of the assay is as low as 1 to 5% depending on the gene abnormality. When compared to IHC (EML4-ALK 5A4 clone; ROS1 D4D6 clone, Cell Signalling) / FISH techniques (Vysis LSI ALK Break Apart Rearrangement Probe Kit, Abbott; ROS1 Split FISH Probe, Abnova), the specificity of the identification of ALK or ROS gene rearrangements is 97%.
Conclusion:
In conclusion, we have developed a promising and performant assay based on an innovative methodology that we have patented for the identification in a single experiment of both gene mutations and gene translocations using very low amounts of DNA extracted from FFPE tumor biopsies or plasma samples.
