Virtual Library

 x 
My Library Virtual Library FAQ

Start Your Search

L. Mas



Author of

  • +

    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
    • +

      P1.01-016 - An International Epidemiological Analysis of Young Patients Diagnosed with NSCLC (AduJov - CLICaP) (ID 6296)

      14:30 - 14:30  |  Author(s): L. Mas

      • Abstract

      Background:
      Eventhough lung cancer remains a disease of a median age at diagnosis of 70y, a proportion of patients are diagnosed at 40y or younger. Patients diagnosed before the age of 40 tend to be never-smokers, are stage IV adenocarcinoma, and tend to have an EGFR activating mutation or a EML4-alk translocation. It is crucial to determine the epidemiological characteristics of patients younger than 40y. Our study groups the largest population of patients less than 40y diagnosed with NSCLC.

      Methods:
      In this epidemiological retrospective study, 249 patients (Argentina=6, Canada=19, Colombia=29, Costa Rica=9, Mexico=89, Nicaragua=2, Panama=19, and Peru=76) with a histologically confirmed NSCLC aged 40 years or less at diagnosis were included. Data included age, gender, histology, stage, EGFR and alk mutation analysis, and date of death or last follow-up. Progression free survival (PFS) and overall survival (OS) were also recorded.

      Results:
      NSCLC patients aged 40 years or less accounted around a 4% of the total NSCLC population. Median age was 34.5 years (range 14-40), 137 (55%) were women, and 192 patients (77.1%) were non-smokers. Adenocarcinoma was the most frequent histological subtype with 203 patients (81.6%) and 24 patients (9.6%) were squamous. 214 patients (85.9%) were stage IV and 23 patients (9.2%) were stage III at diagnosis. The site(s) of metastasis was obtained in 203/214 stage IV patients where 39.9% (n=81) had lung, 35.6% (n=72) had SNC, and 31.7% (n=64) had bone metastasis. EGFR mutation (EGFRm) analysis was determined in 103 patients with 40 patients (38.8%) having an EGFRm. EML4-alk analysis was determined in 165 patients with 11 patients having a positive translocation (6.7%). The OS for all patients was 14.4 months (95%CI=11.2-17.6), PFS was 5.7 months (95%CI=4.9-6.5), and there was no significant difference according to histological subtype. OS for EGFRm(+) was 42 months (95%CI=30.8-54.0) and for EGFRm(-) was 19.4 months (95%CI=14.8-24.0) (p=0.002); PFS for EGFRm(+) was 11.9 months (95%CI=6.3-17.5) and for EGFRm (-) was 7.1 months (95%CI=5.3-8.9) (p=0.005). OS for alk(+) was 28.0 months (95%CI=15.4-40.6) and for alk(-) was 10.6 months (95%CI=6.9-14.3) (p=0.065).

      Conclusion:
      NSCLC patients aged 40 years or less constitute a small but important proportion of patients with this diagnosis. Other risk factors may be involved in the pathogenesis of the disease in this population due to a low smoking history found. SNC metastasis at diagnosis seems to be more frequent in this population. EGFR mutation and EML4-alk translocation frequency is higher than the frequency reported in the general population.

  • +

    P3.03 - Poster Session with Presenters Present (ID 473)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
    • Presentations: 3
    • +

      P3.03-035 - Prognostic Role of hENT1 and RRM1 in Patients with Advanced Pleural Mesothelioma Treated with Second Line Gemcitabine Based Regimens (ID 6328)

      14:30 - 14:30  |  Author(s): L. Mas

      • Abstract

      Background:
      Nucleoside transporter proteins mediates the transport of nucleosides and nucleoside analog drugs across the plasma membrane. The human equilibrative nucleoside transporter 1 (hENT1) is a nucleoside transporter protein that mediates cellular entry of gemcitabine, cytarabine, and fludarabine. The hENT1 expression has been demonstrated to be related with prognosis and activity of gemcitabine-based therapy in breast, ampullary, lung, and pancreatic cancer. In the same way, RRM1 encodes the regulatory subunit of ribonucleotide reductase and is a molecular target of gemcitabine. Previous studies showed increased RRM1 expression on continuous exposure of cell lines to gemcitabine and suggested improved survival for patients with low RRM1 expression.

      Methods:
      We measured hENT1 and RRM1 messenger RNA (mRNA) levels by quantitative real-time reverse transcription-polymerase chain reaction in tumor samples from 29 patients with advanced pleural mesothelioma (APM) treated in second line with gemcitabine based chemotherapy correlating these data with clinical parameters and disease outcomes (overall response rate-ORR, progression free survival-PFS and overall survival-OS).

      Results:
      The median age was 60-yo (r, 33-70 years), 15 patients were males (51%), 34% of cases undergone debulking surgery and the median follow-up was 13.4 months (95%CI 6.4-34). All patients were treated with Pem based chemotherapy in first line achieving a PFS of 8.1 months (95%CI 3.7-12.6), while PFS with second-line Gem based chemotherapy was 6.3 months (95%CI 3.6-8.8). 62% and 34.5% of patients had low levels of mRNA for hENT1 and RRM1, respectively. On univariate survival analysis, the hENT1 expression was associated with OS (p=0.001) and PFS (p=0.022). Specifically, those patients with overexpression of hENT1 showed a shorter OS p=0.021) and a shorter PFS (p=0.033). In contrast, mRNA expression of RRM1 did not influence the OS (p = 0.44) but it modifies positively the PFS (p=0.034). Multivariate analysis found that combined hENT1 (p=0.001) and RMM1 (p=0.012) predict survival in patients with APM treated with Gem based regimens.

      Conclusion:
      hENT1 mRNA expression carries prognostic information in patients with APM and combined with RRM1 holds promise as a predictive biomarkers in gemcitabine treated patients.

    • +

      P3.03-048 - Profiling Response to Chemotherapy in Malignant Pleural Mesothelioma among Hispanics (MeSO-CLICaP) (ID 6319)

      14:30 - 14:30  |  Author(s): L. Mas

      • Abstract

      Background:
      Malignant pleural mesothelioma (MPM) is a rare malignant disease, and the understanding of molecular pathogenesis has lagged behind other malignancies.

      Methods:
      A series of 53 formalin-fixed, paraffin-embedded tissue samples with clinical annotations were retrospectively tested for BAP1 and PI3K mutations and for mRNA expression of TS and EGFR. Immunohistochemistry staining for CD26 (dipeptidyl-peptidase IV, DPP-IV) and Fibulin3 (Fib3) proteins were also performed. Outcomes like progression free survival (PFS), overall survival (OS) and response rate (ORR) were recorded and evaluated according to biomarkers. Cox model was applied to determine variables associated with survival.

      Results:
      Median age was 58 years (range 36-76), 27 (51%) were men, 89% were current or former smokers, and six patients had previous contact with asbestos. 77% had a baseline ECOG 0-1 and almost all patients (n=52/98%) received cisplatin or carboplatin plus pemetrexed (Pem) as first line; 58% of them were treated with Pem as maintenance for a mean of 4.7 +/-2.8 cycles. 53.5% and 41.5% of patients were positive for CD26 and fibulin-3, while 49% and 43.4% had low levels of EGFR and TS mRNA, respectively. The majority of epithelioid and biphasic types expressed CD26 (p=0.008), Fibulin3 (0.013) and had lower levels of TS mRNA (p=0.008). Mutations in PI3K (c.1173A> G, c.32G> C and c.32G> T) were found in 5 patients and only one patient had a mutation in BAP1 (c.241T> G). First line PFS were significantly longer in CD26+ (p=0.0001), in those with low EGFR mRNA expression (p=0.001), in patients with positive Fib3 (p=0.006) and lower TS mRNA expression (p=0.0001). OS were significantly higher in patients with CD26+ (p=0.0001), EGFR- (p=0.001), Fib3 + (p=0.0002) and low TS mRNA expression level (p=0.0001). Multivariate analysis found that CD26+ (p=0.012), Fib3 (p=0.020) and TS mRNA levels (p=0.05) were independent prognostic factors.

      Conclusion:
      CD26, Fib3 and TS were prognostic factors significantly associated with improved survival in patients with advanced MPM.

    • +

      P3.03-060 - Characteristics and Long Term Outcomes of Advanced Pleural Mesothelioma in Latin America (MeSO-CLICaP) (ID 6265)

      14:30 - 14:30  |  Author(s): L. Mas

      • Abstract

      Background:
      Malignant pleural mesothelioma (MPM) is an aggressive tumor, usually associated with a poor prognosis. MPM is a heterogeneous disease often associated with different clinical courses. Palliative platinum-based chemotherapy may help to improve symptoms and prolong life.

      Methods:
      The MeSO-CLICaP registry identified 124 patients with advanced MPM from 5 Latin American countries diagnosed and treated between January 2008 and March 2016. Data collected included age, gender, asbestos exposure, presenting signs/symptoms, performance status, histology, stage, treatment modalities including chemotherapy, and date of death or last follow-up. Outcomes like progression free survival (PFS), overall survival (OS) and response rate (ORR) were recorded. Cox model was applied to determine variables associated with survival.

      Results:
      median age was 59.5 years (range 33-84), 72 (58%) were men, 69% were current or former smokers and 37 patients (30%) had previous exposure to asbestos. Ninety-six patients (77%) had a baseline ECOG 0-1, 102 (82%) were epithelioid tumors, 47 (38%) and 77 (62%) cases had stage III or IV MPM. Only 20% (n=25) underwent pleurectomy, 28% (n=35) received radiotherapy and 123 patients received platinum-based chemotherapy in first line (plus Pem 68/54% and Gem 55/44%). ORR to first line chemotherapy was 48% (CR 3.2%/PR 43%), PFS was 10.5 months (95%CI 8.2-12.8) and 47 patients had Pem maintenance (mean number of cycles 4.4+/-3). Median OS was 25.3 months (95%CI 22.3-28.3) and according to a univariate analysis, stage (p=0.03), histology (p=0.005), and Pem manteinance (p=0.014) were associated with better OS. Multivariate analysis found that stage (p=0.002), histology (p=0.021), smoking history (p=0.001) and Pem manteinance (p=0.002) were independent prognostic factors.

      Conclusion:
      Our study identifies factors associated with a clinical benefit from chemotherapy among Hispanic patients with advanced MPM, and emphasizes the impact of histology and clinical benefit of chemotherapy on outcomes.