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V. Frappat
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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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P1.01-039 - Does Distance between Chest and Surgery Departments Impact Outcome in Lung Cancer Patients? Results of KBP-2010-CPHG Study (ID 4585)
14:30 - 14:30 | Author(s): V. Frappat
- Abstract
Background:
We studied the impact of the distance between chest and thoracic surgery departments on the outcome of patients followed, for primary lung cancer diagnosed in 2010, in the chest department of 104 French general hospitals participating in KBP-2010-CPHG study.
Methods:
6,083 patients with non-small-cell lung cancer (NSCLC) participated in this study. Univariate and multivariate analyses were performed to identify independent factors for surgery and 1-year mortality. Distance from the usual thoracic surgery department in 2010 was collected for each chest department and included in the model as a 4-class variable: 0 km (same hospital), 1-34 km, 35-79 km, and ≥80 km.
Results:
Overall, 23% of hospitals had a thoracic surgery department; otherwise, mean distance between the hospital and the surgical center was 65 km. 1,157 patients (19%) were operated on; vital status was known for 5,876 patients (97%). Distance was not an independent factor for surgery and for mortality. Independent factors for surgery and mortality are presented in Tables 1 and 2. Table 1- Surgery (multivariate analysis: adjusted odd-ratios)
Table 2- Mortality (multivariate analysis: adjusted hazard-ratios)OR 95% CI p Distance (km) 0 1 1-34 0.97 [0.74-1.27] 0.833 35-79 0.88 [0.66-1.18] 0.399 >=80 1.02 [0.78-1.32] 0.91 Age (year) Continuous 0.95 [0.94-0.96] <0.001 Stages IV 1 I 248.18 [172.48-357.11] <0.001 II 155.78 [107.70-225.32] <0.001 IIIA 34.23 [24.80-47.25] <0.001 IIIB 2.33 [1.40-3.89] 0.001 Histology Adenocarcinoma 1 Squamous-cell carcinoma 0.77 [0.61-0.96] 0.023 PS PS0 1 PS1 0.58 [0.47-0.71] <0.001 PS2 0.12 [0.08-0.17] <0.001 PS3 0.08 [0.04-0.16] <0.001 PS4 0.07 [0.02-0.32] <0.001 HR 95% CI p Distance (km) 0 1 1-34 1.02 [0.94-1.11] 0.661 35-79 1.00 [0.91-1.10] 0.985 >=80 1.01 [0.93-1.09] 0.887 Age (year) Continuous 1.01 [1.01-1.01] <0.001 Sex Men 1 Women 0.86 [0.80-0.94] <0.001 Stages IV 1 I 0.15 [0.13-0.18] <0.001 II 0.29 [0.25-0.34] <0.001 IIIA 0.41 [0.37-0.46] <0.001 IIIB 0.65 [0.58-0.72] <0.001 PS PS0 1 PS1 1.58 [1.45-1.73] <0.001 PS2 2.79 [2.52-3.09] <0.001 PS3 5.75 [5.11-6.48] <0.001 PS4 10.2 [8.52-12.20] <0.001 Smoking Never-smoker 1 Former-smoker 1.18 [1.05-1.33] 0.005 Current-smoker 1.33 [1.18-1.49] <0.001
Conclusion:
In 2010, the absence of an on-site thoracic surgery department did not impair outcome in NSCLC patients managed in the chest departments of French general hospitals.
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P1.07 - Poster Session with Presenters Present (ID 459)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.07-012 - Efficacy of Immune Checkpoint Inhibitors in Large Cell Neuroendocrine Lung Cancer: Results from a French Retrospective Cohort (ID 4613)
14:30 - 14:30 | Author(s): V. Frappat
- Abstract
Background:
Nivolumab and pembrolizumab, two programmed death (PD)-1 immune-checkpoint–inhibitor antibodies, demonstrated superiority versus standard chemotherapy in second- third line in both squamous and non-squamous lung cancer. Large cell neuroendocrine lung cancer (LCNEC) is a rare tumour often treated as a small cell lung cancer, but there is not a standard of care after a first line progression. Aim of the study was to assess clinical efficacy of PD-1 inhibitors in these patients.
Methods:
We retrospectively reviewed all consecutive LCNEC stage IIIB- IV patients treated with nivolumab or pembrolizumab after platinum-based first line therapy between July 2014 and November 2015 in six French centres. Patients were followed until June 2016. The drugs were given in an early access program or a clinical trial.
Results:
The analysis included 10 patients with advanced stage disease. Eight patients (80%) had a stage IV disease with a median age of 59 [interquartile range (IQR) 55-62] years. The majority were males (n=9; 90%), with good performance status (0-1; 9/90%) and 50% were treated in third line or further. Three patients presented brain metastases. In 5 cases a molecular test was done, finding in one case (20%) a KRAS mutation. Patients received a first line treatment with platinum and etoposide in 8 cases (80%) with a disease control rate of 50%. Nine patients received nivolumab and the PD-L1 status was never performed, while the patient treated with pembrolizumab expressed PD-L1. Patients received a median number of 16 [IQR, 13-18] cycles, 6 showed a partial response (60%), 1 a stable disease (10%). Median PFS was 57 [24-57] weeks. Most of the patients stopped treatment due to disease progression (n=4; 80%), only one for a pulmonary interstitial pneumonia.
Conclusion:
Our findings suggest that the use of immune-checkpoint–inhibitors in LCNEC could be explored in a larger cohort of patients. This treatment could be considered in the scenario of a disease with limited therapeutic strategy.
