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M. Miyasaka



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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
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      P1.03-025 - Serum KL-6 Levels in Patients with Lung Cancer (ID 4236)

      14:30 - 14:30  |  Author(s): M. Miyasaka

      • Abstract

      Background:
      Serum levels of KL-6 are widely used as an indicator of activity of interstitial lung disease. Although KL-6 was initially developed as a serum marker for malignancies, it is still unknown if KL-6 can be used as a biological marker of lung cancer. This study aimed to determine the properties of serum KL-6 levels in patients with lung cancer.

      Methods:
      First, serum KL-6 elimination kinetics after resection of lung cancer was investigated in 7 patients. Postoperative time course of serum KL-6 levels was analyzed using non-linear least square analysis with the fitting equation; C(t)=C~0~exp(-kt)+Cp, where k is the rate constant of elimination. The biological half-life was calculated as log~e~2/k. Next, serum KL-6, CEA, and CYFRA levels of patients with lung cancer and benign chest disease were retrospectively reviewed. A total of 226 patients with lung cancer and 103 patients with benign chest disease were included in this study. Serum KL-6 levels were measured using the electrochemiluminescence immunoassay method. The cut-off level of KL-6 was 500 U/ ml.

      Results:
      Rate constant of elimination and biological half-life of KL-6 in initial 7 patients were 0.827±0.275 day[-1] and 0.93±0.35 day, respectively. These data implies that lung cancer cells produce KL-6 molecule and release it into the serum. Among 329 patients, serum KL-6 levels were above the cut-off level in 44 patients (19.5%) with lung cancer and 4 patients (3.9%) with benign chest disease. The mean serum KL-6 level in patients with lung cancer was significantly (p=0.0027) higher (375 ± 232 U/ ml) than that in patients with benign chest disease (296 ± 177 U/ml). Serum KL-6 levels in patients with lung cancer were significantly correlated with tumor size (p<0.0001), stage (p<0.0001), and individual TNM descriptors (T; p<0.0001, N; p=0.0047, M; p=0.0003). ROC analysis revealed that AUC of KL-6 was 0.6348 (p=0.0015), and that was inferior to CEA (AUC=0.8127, p<0.0001) and CYFRA (AUC=0.7103, p<0.0001). The sensitivity, specificity, true positive rate, true negative rate, and accuracy of KL-6 were 19.5%, 95.0%, 91.7%, 35.2%, and 43.5%, respectively.

      Conclusion:
      Serum KL-6 levels are well correlated with the progressiveness of lung cancer. KL-6 might be useful as a biological marker to monitor the recurrence and the effect of therapy in lung cancer.

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    P3.02c - Poster Session with Presenters Present (ID 472)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P3.02c-014 - Patients with Recurrence after Resection of Lung Cancer Are Good Candidates for the beyond over Progressive Disease Application of Bevacizumab (ID 3997)

      14:30 - 14:30  |  Author(s): M. Miyasaka

      • Abstract

      Background:
      The benefit of the continuation of bevacizumab (BEV) beyond over progressive disease (PD) in patients with non-small cell lung cancer (NSCLC) has not been clarified yet. We present our experience of chemotherapy with BEV continuation beyond over PD in patients with recurrent NSCLC after surgery.

      Methods:
      They were consisted of 19 patients. There were 10 males and 9 females, and their age at surgery was 69±10 (41-85) years old. Lobectomy was done in 18 patients, and segmentectomy in 1. Pathological stage was IA in 5, IB in 3, IIB in 3, IIIA in 5, IIIB in 1, and IV in 2. Recurrence was observed at 630±460 days after surgery. Sixteen patients among them had been received some chemotherapy protocols before usage of BEV for 507±448 days. Performance status before treatment was grade 0 in 11 patients, 1 in 7, and 3 in 1. Chemotherapy was performed intending to continue BEV beyond over PD in these patients.

      Results:
      The average number of protocols with BEV was 3±1 (1-5). BEV was used for 1734±413 days. Side effects (≥ grade 2) due to BEV were hypertension in 6 patients, proteinuria in 4, and hemoptysis in 1. Seven patients were died of cancer, and 1 of COPD worsening. Five-year survival rate after surgery, after recurrence, and after initiation of BEV was 81.2%, 45.0%, and 31.2%, and median survival time was 2384 days, 1661 days, and 1105 days, respectively.

      Conclusion:
      The majority of patients with operable NSCLC have good performance status. Moreover, we can detect their recurrence in the early periods at most before the symptoms appear, because of the regular examinations. Therefore, these patients are at an advantage that they can receive more chemotherapy protocols. In these selected patients, their prognosis may be prolonged by the continuation of BEV beyond over PD.