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M.F.E. Simões
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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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P1.01-033 - EGFR Mutation and ALK: Are Patients Being Adequately Tested in Brazil? (ID 5818)
14:30 - 14:30 | Author(s): M.F.E. Simões
- Abstract
Background:
Lung cancer is one of the most common malignancies in the world. In Brazil, it is estimated that 28,200 new cases will be diagnosed in 2016. This cancer affects more men and is usually caused by tobacco exposure. The most common histology is adenocarcinoma and many of these patients have driver mutations which help guide therapeutic choice. The aim of this study was to delineate the epidemiological profile of patients with NSCLC in Brazil and to evaluate the prevalence of testing for ALK translocations and EGFR mutations in patients in the public and private settings in Brazil.
Methods:
Observational, descriptive, retrospective, multicenter study involving 230 public and private institutions in Brazil. We obtained data from a commercial database with 1642 Non Small Cell Lung Cancer (NSCLC) patients treated in the country between January and December 2015. Variables analyzed: age, sex, smoking, presence of EGFR and ALK mutation.
Results:
Out of 1642 patients, 814 were treated in the public service (49.57%) and 828 in private services (50.42%). Most patients were men (58.28% vs. 41.71% female). The mean age at diagnosis was 61.8 years (median 62 years), 32.58% were former smokers, 31.12% current smokers, 19.48% never smoked and data were not available for 16.8% of subjects. Most patients had metastatic disease at diagnosis (65.04%), 23.20% had stage III, 9.31% stage II and 2.43% stage I. 68.57% had adenocarcinoma, 27.52% squamous cell cancers, 1.4% large cell and 2.67% had other histological types. Among the 534 patients with non-squamous histology treated in public settings, 244 patients were tested for EGFR (46,69%) and only and only 36 were tested for ALK (6,74%).In private services, of 656 patients with non-squamous subtypes, 454 were tested for EGFR (69,2%) and 77 for ALK (11,73%).
Conclusion:
Overall, testing for EGFR mutations was below ideal, especially in the public setting. More worryingly, and likely due to the lack of availability of crizotinib in Brazil until 2016, very few patients were tested for ALK translocations in 2015. Much work needs to be done in education and advocacy to improve testing patterns in the country.
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P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.02-030 - Consolidation Chemotherapy Following Concurrent Chemoradiation for Stage III Non-Small Cell Lung Cancer: A Brazilian Multicentric Cohort (ID 4670)
14:30 - 14:30 | Author(s): M.F.E. Simões
- Abstract
Background:
Locally advanced stage III grossly accounts for 25% newly diagnosed non-small cell lng cancer (NSCLC) cases. Albeit some patients (pts) are amenable to surgical resection, most will be treated with concurrent chemoradiation (CRT), whilst the addition of consolidation chemotherapy (CC) is still a debatable topic. We decided to look into the impact of CC in stage III NSCLC Brazilian pts treated in the daily clinical practice.
Methods:
We retrospectively collected data of stage III NSCLC pts treated in five different Brazilian cancer institutions from Jan/2007 to Dec/2011, whom have received CRT followed or not by CC. Eligible pts were ≥18yo and must have been treated with cisplatin or carboplatin plus etoposide, paclitaxel or vinorelbine, concurrently with thoracic irradiation (RT). Patients treated with surgery or neoadjuvant chemotherapy were excluded. Primary endpoint was overall survival (OS) from the date of diagnosis. Association between CC and clinical variables and demographics were evaluated by Pearson´s Chi-square test (Χ²). Survival curves were calculated by Kaplan-Meier method and compared by log-rank test. Univariate and multivariate analysis were made using Cox proportional model (CPM). P-values<0.05 were deemed statistically significant.
Results:
We collected data from 165 pts. Median age was 60yo (range: 27-79) and most pts were male (69.1%), Caucasian (77.9%), current or former smoker (93.3%), and staged as IIIB (52.7%). Adenocarcinoma was the most common histologic type (47.9%). Weight loss>5% and ECOG-PS 2 were observed in 39.1% (n=61) and 14.6% (n=24), respectively. Median follow-up was 25 mo. CC was administered to 27 pts. The only variable associated with CC was T stage (Χ²(4) = 11.410, p=0.022), with more T3 tumors receiving CC than expected. We observed no statistically significant difference in OS between patients treated or not with CC (p=0.211), although 3-year OS rate was numerically higher in CC pts (40% vs. 31%). Median OS in was 24 and 25 months in CC and no CC groups, respectively (HR 1.408, 95%CI 0.814-2.434). A total delivered RT dose ≥ 61Gy was the only variable independently associated with improved survival (HR 0.617, 95%CI 0.419-0.909, p=0.012).
Conclusion:
CC did not improve OS in stage III NSCLC patients after concurrent CRT. RT dose < 61 Gy negatively impacted OS.
