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J. Blay
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P1.01 - Poster Session with Presenters Present (ID 453)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Epidemiology/Tobacco Control and Cessation/Prevention
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.01-010 - Awareness of Lung Cancer Risk Factors among Lay Persons and Physicians (ID 4686)
14:30 - 14:30 | Author(s): J. Blay
- Abstract
Background:
Tobacco consumption, and more specifically active smoking, remains the main risk factor for lung cancer (LC) and continues to be the target of awareness campaigns worldwide. However, in recent decades, other risk factors have been identified, including passive smoking, atmospheric pollution and occupational exposure. This analysis focuses on awareness of LC risk factors among the lay population and physicians.
Methods:
The 4th French nationwide observational survey, EDIFICE 4, was conducted by phone interviews of a representative sample of 1602 subjects, aged between 40 and 75 years, from June 12 to July 10, 2014. A mirror survey was also conducted by phone among physicians between July 9 and August 8, 2014. Both surveys were conducted using the quota method on representative samples of 1602 lay persons and 301 physicians. The following analyzes were conducted amongst 1463 lays persons with no history of cancer and 301 physicians. Interviewees were asked to cite the five main risk factors for LC.
Results:
LC risk factors associated with tobacco in general were widely cited in first position by both physicians and the lay population (100% and 96%, respectively; P≤0.01), with the role of active smoking (100% vs 94%, P≤0.01) and passive smoking (77% vs. 68%, P≤0.01) clearly identified. Twice as many physicians cited asbestos as a risk factor, ranking it in second place, compared with the lay population (77% vs. 30%, P≤0.01). Atmospheric pollution was cited to the same degree by physicians and the lay population (49% vs. 43%, P=0.05), the latter ranking it second. Heredity and family history came fourth (32% vs. 13%, P≤0.01) and alcohol fifth (13% vs. 10%, not statistically significant), in both populations. Infections and other respiratory disorders were cited by less than one person in ten (7%). Poor dietary habits were very rarely cited by either physicians or the lay population (<1% vs 4%, respectively, P≤0.01).
Conclusion:
The awareness of risk factors for lung cancer is broadly consistent with the established risk factors, among both physicians and the lay persons in our survey. As expected, tobacco was ranked first, followed by atmospheric pollution and asbestos, though the latter is less present in the mind of the lay population compared to physicians. It is noteworthy that even among physicians, a history of respiratory disorders was only marginally acknowledged.
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P1.03 - Poster Session with Presenters Present (ID 455)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.03-040 - Beliefs Surrounding Lung Cancer Screening among Physicians and Lay Populations: Results from the EDIFICE Survey (ID 4436)
14:30 - 14:30 | Author(s): J. Blay
- Abstract
Background:
The National Lung Cancer Screening Trial has shown that lung cancer screening (LCS) with an annual low-dose chest CT-scan reduces specific mortality in both former and current heavy smokers. However, organizational issues have yet to be solved before it can be systematically implemented. We investigated the perceptions of the population at large as well as those of physicians with regard to the efficacy of LCS, and target populations in terms of tobacco use.
Methods:
The 4th French nationwide observational survey, EDIFICE 4, was conducted by phone interviews of a representative sample of 1602 subjects, aged between 40 and 75 years, from June 12 to July 10, 2014. A mirror survey was also conducted by phone among physicians between July 9 and August 8, 2014. Both surveys were conducted using the quota method on representative samples of 1463 lay persons and 301 physicians with no history of cancer.
Results:
For 53% of lay persons and 33% of physicians interviewed (P<0.01), generalization of LCS is potentially an effective way to reduce lung cancer mortality. For the majority of interviewees (58% of lay persons and 55% of physicians; difference not statistically significant [NS]), offering LCS to the whole population would not encourage smokers to continue smoking. The table shows lay persons’ and physicians’ replies concerning possible target populations within the whole population and among smokers. Figure 1
Conclusion:
Lay persons are more inclined to suggest generalizing LCS to the whole population, independently of current smoking status or quitting issues. Lay persons and physicians alike agree with generalizing LCS to all smokers, regardless of their tobacco consumption.
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P3.02a - Poster Session with Presenters Present (ID 470)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02a-034 - Vemurafenib in Patients with Non-Small Cell Lung Cancer (NSCLC) Harboring BRAF Mutation. Preliminary Results of the AcSé Trial (ID 4924)
14:30 - 14:30 | Author(s): J. Blay
- Abstract
Background:
BRAF is found mutated in 2-3% of stage IV NSCLC. BRAF inhibitors have been reported to have antitumor activity. A nationwide access to vemurafenib for cancer patients with tumors presenting with BRAF mutations was launched by the French National Cancer Institute (INCa) providing free access to tumor molecular diagnosis. The AcSé-Vemurafenib study is the 2[nd] exploratory multi-tumor 2-stage design phase II trial of AcSé program. We report the preliminary results of the NSCLC cohort in this nationwide program.
Methods:
BRAF mutational status was assessed on INCa molecular genetic platforms by either direct sequencing or NGS. Patients with BRAF mutation (including BRAF V600E and others less common mutations), progressing after at least one standard treatment (including a platinum-based doublet, unless pts were considered as unfit for chemotherapy) were proposed to receive vemurafenib 960 mg BID. Responses were centrally assessed using RECIST v1.1 every 8 weeks.
Results:
From Oct. 13, 2014 to June 15, 2016, 65 patients were enrolled including 55 NSCLC harboring BRAF V600E and 10 pts with other activating mutations (2 G466, 3 G469, 1 G596, 3 K601 and 1 N581). 55 patients received vemurafenib and had at least one post-baseline assessment. Median age: 67 years (range 40–84), 51% females and 100% non-squamous histology. Median number of prior chemotherapy lines: 1 (0 –5). Most frequent grade ≥3 adverse events (AEs) were skin (18% of patients) and gastrointestinal toxicities (16%). Among the 39 BRAF V600E NSCLC patients evaluable for the best overall response (BOR) with a minimum follow-up of 4 months, 15 PR, 8 SD, 10 PD, 5 deaths before assessment and 1 missing were observed. The objective response rate was 38.5% [95% CI:23.4-55.4], and the disease control rate 59% [42.1-74.4]. Median duration of response was 5.1 months [1.8-9.2]. Progression-free survival (PFS) at 4 months was 48.2% [31.8-62.8]. No response was reported among the 7 evaluable patients with other BRAF mutations with 5 PD, 1 death before assessment and 1 missing as BOR ; PFS at 4 months was 14.3% [0.7-46.5]. 18 patients were still on treatment at the cut-off date, 47 have stopped vemurafenib (25 PD, 15 AEs, 1 death, 1 doctor’s decision, 5 patient’s decisions).
Conclusion:
Vemurafenib provided response rate and DCR in BRAF V600E pretreated NSCLC but was not found efficient in NSCLC with other BRAF mutations. These results underline the interest of integrating BRAF V600E in biomarkers routine screening.
