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M.A. Lewandowska



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    P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P2.02-011 - Optimal Strategy to Prevent Atrial Fibrillation in Patients Undergoing Pulmonary Resection for Lung Cancer. Network Meta-Analysis (ID 2383)

      09:30 - 09:30  |  Author(s): M.A. Lewandowska

      • Abstract
      • Slides

      Background:
      Atrial fibrillation (AF) after pulmonary resections for lung cancer, although transient in most cases, occurs in up to 30% following lobectomy and up to 65% after pneumonectomy and might, in turn, lead to serious adverse events including stroke, myocardial infarction and death. Different preventive measures have been investigated, however because of paucity of evidence from randomized studies, straightforward recommendations are still uncertain. We aimed to perform a Bayesian-framework mixed treatments comparison (network) meta-analysis of both randomized controlled- (RCTs) and observational studies, to investigate the net-relative benefit of diverse drugs in prevention of atrial fibrillation following pulmonary resections for lung cancer.

      Methods:
      We screened Medline, Google Scholar, EMBASE and Cochrane CENTRAL registries for randomized and observational studies comparing drugs to each other and/or to placebo. Studies with post-operative AF as prespecified end-point were retrieved for detailed abstraction. Primary outcome was assessed at longest available follow-up.

      Results:
      Overall 15 studies (13 RCTs) were identified, enrolling N=1753 patients. Beta-blockers, Atrial Natriuretic Peptide and Flecainide were associated with significant relative reduction in odds of postoperative AF, OR (2.5-97.5% CrI) of 0.34 (0.02-0.92); 0.35 (0.00-0.94) and 0.11 (0.00-0.46) respectively; Digoxin was found to increase these odds. Addition of observational data allowed for identification of Amiodarone as another potentially preventive treatment OR (2.5-97.5% CrI) 0.28 (0.03-0.69). Bayesian posterior probability curves revealed the ranking among treatments with Flecainide, beta-blockers, ANP and Amiodarone being associated with the highest probability to reduce the odds of AF, magnesium and calcium blockers with virtually no effect and digoxin found inferior to placebo. Figure 1



      Conclusion:
      Beta-blockers and Flecainide are effective in reducing the incidence of postoperative AF in patients after pulmonary resections which is not the case with digoxin; data on remaining treatments are sparse and preclude drawing definite conclusions.

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    P2.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 234)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Biology, Pathology, and Molecular Testing
    • Presentations: 1
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      P2.04-012 - The Development of EGFR Mutation Diagnostic Program for NSCLC Patients in Poland (2011-2014) (ID 2299)

      09:30 - 09:30  |  Author(s): M.A. Lewandowska

      • Abstract
      • Slides

      Background:
      Targeted therapy of non-small cell lung cancer necessitates fast and reliable molecular evaluation of tissue/cytologic samples within the routine diagnostic process. Here we present the dynamic development of the EGFR mutation screening program for NSCLC patients in Poland within the previous 4 years.

      Methods:
      In total, 287 samples were analysed for EGFR mutations in 2011 (13.3% positive, 3% unsuitable for diagnostics), 1249 (9.2%, 1.5%) in 2012, 2104 (10.1%, 1.9%) in 2013, 4307 (10.2%, 2.7%) in 2014. Adenocarcinomas were 85.9% in 2012, 93.2% in 2014. The percentage of NSCLC NOS materials decreased continuously (10% down to 5.3%). 72% of samples contained >50% of cancer cells, 15% - 20-50%, 5.5% - 10-20%, 7.5% - below 10%.

      Results:
      Between 2011-2014, 727 activating EGFR mutations were identified, including 5.8% in exon 18, 58.5% in exon 19, 35.7% in exon 21, and 83 in exon 20 (10%). Currently, all laboratories employ CE-IVD real-time PCR tests as diagnostic method of choice. Additionally, 3 labs use alternative diagnostic methods as well. Results are available within 48 hrs (1 lab), 3-5 days (3 labs), 6-7 days (2), >8 days (2). All centres participate in the external quality schemes.

      Conclusion:
      The diagnostic program provides fast and reliable diagnostics of EGFR mutation in NSCLC patients in Poland.

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