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A. Green
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P1.02 - Poster Session with Presenters Present (ID 454)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.02-034 - EGFR Mutations and ALK Translocations in Lung Cancer - A National Study (ID 5376)
14:30 - 14:30 | Author(s): A. Green
- Abstract
Background:
The Danish Lung Cancer Registry (DLCR) has since 2003 reported all cases of lung cancer in Denmark. Since 2012 data on EGFR mutations and ALK translocations have been included. Little is known on the distribution of EGFR mutations and ALK translocations on a national level in a primarily Caucasian population like the Danish lung cancer population.
Methods:
All Danish lung cancer patients are ascertained based on coded information in the National Patient Register. Supplementary information for each patient is obtained from the clinical units as well as from the National Pathology Register (NPR). Based on SNOMED coding by all departments performing lung cancer pathology evaluation and registered in the NPR the subgroups of lung cancer are identified. The patients are tested for EGFR mutations and ALK translocations according to national guidelines and the results are registered in the NPR. It is estimated that 95 % of all Danish lung cancer patients are present or former smokers and that the sex distribution is equal between the sexes.
Results:
4667 patients diagnosed in 2015 are included. Table 1. Distribution of EGFR mutations and ALK translocation in the 2015 lung cancer population: Figure 1 83.3 % of all patients with lung cancer and adenocarcinoma in Denmark are tested for EGFR mutations and 9.4 % are positive. 73.1 % of adenocarcinomas are tested for ALK translocations and 1.4 % is found to be positive. In total only 8.8 % of all tested lung cancer patients are found to be EGFR mutated and 1.3 % has an ALK translocation.
Conclusion:
Data from primarily Asian lung cancer populations have shown significant higher rates of EGFR mutations and ALK translocations that the findings in this Danish population. Based on these data the cost-effectiveness of the chosen strategy for reflex testing lung cancer patients up front should be reconsidered.
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P3.01 - Poster Session with Presenters Present (ID 469)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.01-020 - Evolving Trends in Lung Cancer Pathology (ID 5344)
14:30 - 14:30 | Author(s): A. Green
- Abstract
Background:
The Danish Lung Cancer Registry has since 2003 reported all cases of lung cancer in Denmark including the pathology. We present the trends over time in the distribution of subgroups of pathology.
Methods:
All Danish lung cancer patients are ascertained based on coded information in the National Patient Register. Supplementary information for each patient is obtained from the clinical units as well as from the National Pathology Register (NPR). Based on SNOMED coding the patients is categorized in 12 subgroups of lung cancer.
Results:
Table 1. Distribution of pathology subgroups, n = 56,554: Figure 1 Figure 1. Trends in lung cancer pathology (%) Figure 2 The increased number of lung cancer falls mainly in the adenocarcinoma group. Moreover, there is a significant relative increase of adenocarcinomas corresponding with a decrease of patients with NOS and NSCC. The occurrences of the other categories, including small cell carcinoma and squamous carcinoma, have remained largely unchanged.
Conclusion:
The trend of adenocarcinoma as the predominate type of lung cancer is in accordance with the global evolution. The high frequency is partly due to the need for specific subtyping and the agreement of diagnostic criterias which has resulted in a shift from NOS and NSCC categories to adenocarcinoma.
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P3.02b - Poster Session with Presenters Present (ID 494)
- 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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P3.02b-056 - Survival in EGFR Mutated Advanced Lung Cancer Adenocarcinoma Patients - A National Study (ID 5378)
14:30 - 14:30 | Author(s): A. Green
- Abstract
Background:
The Danish Lung Cancer Registry (DLCR) has since 2003 reported all cases of lung cancer in Denmark. Since 2012 data on EGFR mutations and ALK translocations have also been included in the registry. The significance of being EGFR mutated on survival in a national population has not yet been reported.
Methods:
All Danish lung cancer patients are ascertained based on coded information in the National Patient Register and the National Pathology Register (NPR). Based on SNOMED coding the subgroups of lung cancer and the EGFR mutation status is identified. The study includes all Danish stage IIIB and IV lung cancer adenocarcinoma patients diagnosed between 2013 and 2015. Treatment modalities including EGFR inhibitors followed international guidelines. Survival of the EGFR mutated patients has been compared to EGFR negative patients and those without any EGFR registration. Prognostic factors were analyzed in a Cox uni- and multivariate analysis.
Results:
Among 3120 patients identified, 244 were EGFR positive, 2404 EGFR negative and 472 not tested, respectively. Figure 1: Kaplan Meier for survival of adenocarcinoma patients stage IIIb and IV: Figure 1 Median survival for EGFR positives was 544 days, against 203 for EGFR negatives and 114 for untested. The EGFR mutated group had more female patients, never smokers and lower Charlson Comorbidity Index (CCI) than the 2 other groups. Supplementary data on population characteristics and treatment are to be presented. In univariate Cox analysis EGFR was an independent predictor for survival (HR: 0.68 (95 % CI: 0.82-0.74); P= 0.000) and in the multivariate analysis adjusted for age, sex, smoking and CCI the effect of EGFR was independent (HR: 0.72 (95% CI: 0.69 – 0.80); P= 0.000).
Conclusion:
In a nationwide total population of advanced lung cancer adenocarcinoma patients, EGFR positives gain approximately 1 year in median overall survival compared to EGFR negatives and untested patients.
