Virtual Library

 x 
My Library Virtual Library FAQ

Start Your Search

J. Hernando



Author of

  • +

    P1.05 - Poster Session with Presenters Present (ID 457)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Early Stage NSCLC
    • Presentations: 1
    • +

      P1.05-005 - Programmed Death-Ligand 1 (PD-L1) in Resected Lung Adenocarcinomas (LA) in a University Hospital (ID 6101)

      14:30 - 14:30  |  Author(s): J. Hernando

      • Abstract

      Background:
      The role of monoclonal antibodies inhibiting of the Programmed Death-1 and its ligand (PD-1/ PD-L1) pathway have been described in advanced disease. The knowledge of the role of this pathway in early stages of lung cancer is still limited. We assessed the incidence of PD-L1 expression in tumour cells of samples of resected lung adenocarcinomas and its prognostic role.

      Methods:
      A retrospective analysis of patients (p) with lung adenocarcinomas radically resected at our Institution between 2004 and 2011 has been conducted. PD-L1 was determined by Immunohistochemistry (SP263, Ventana® assay). A cut-off value of 5% of positive tumour cell was chosen.

      Results:
      112 tumours from 107 p were included. Median age was 62 years. 81% were male, 88% had exposure smoking, baseline performance status was 0 – I – II (62,5% - 26,8% - 10,7%) and pathological stage was I – II – III – IV (49,1% - 26,8% - 23,2% - 0,9%). Fourteen p (12%) expressed PD-L1>5%. They were mostly male (71%), smokers (93%), baseline performance status was 0 – 1 – 2 (64% - 29% - 7%), the most common histological subtype was poorly differentiated adenocarcinoma (64%) and pathological stage was I – II – III (28% - 21% - 50%). One p (7,7%) harboured EGFR mutation, none (0%) were ALK positive and 6 p (46,2%) had a K-RAS mutation. With a follow-up of 52 months median disease free survival (DFS) was 49 months and overall survival (OS) 58 months. Median DFS was shorter in p with expression of PD-L1 (27 months) that in negative tumours (49 months) (p=0,45). Median OS showed a similar pattern (32 vs 66 months respectively) also favouring PD-L1 negative p (p=0,05).

      Conclusion:
      In our series, patients with resected adenocarcinomas expressing PD-L1 in >5% of cells showed a worse disease free and overall survival than patients without such expression.

  • +

    P1.06 - Poster Session with Presenters Present (ID 458)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
    • +

      P1.06-028 - Description of the Patients with Advanced Squamous NSCLC Treated in a Single Institution (ID 6171)

      14:30 - 14:30  |  Author(s): J. Hernando

      • Abstract

      Background:
      Squamous carcinomas are a distinct subtype of NSCLC. Even if it is no longer the most frequent one, still remains a significant percentage of NSCLC patients in our practice. Besides, clinical presentation, associated comorbidities and available therapies are different for non-squamous subtypes. Assessing their characteristics may help to optimize therapy.

      Methods:
      DAta from patients with a diagnosis of advanced (stage IV patients plus patients with lower stages but not amenable for any local therapy) squamous NSCLand treated in our Hospital between 2009-15 were reviewed.

      Results:
      209 patients (p) were found. Median age was 69 years (40-89). Gender: Male in 89.5%. PS: ECOG 0= 9.1%, 1= 45.9%, 2= 38.3%, 3= 6.7%. By stage, I= 0.5%, II 3.4%, III 27.7%, IV 68.7%. Therapy: 29.1% of p did not receive any systemic therapy and 70.9% receive chemotherapy (CT). CT included a platinum in 69p (carboplatin 47p, cisplatin 22p) and 61p received a non-platinum scheme (gemcitabine-vinorelbine 21p, monotherapy 40 p (gemcitabine 8p, oral vinorelbine 23p, other 9p). Patients with better PS (p<0.001) and stage less than IV (0.02) were more probable to receive CT and also that CT given included platinum. Overall survival (OS) was 6.5 months (5.4-7.6) for the whole group. For stage IV patients, it was significantly shorter: 5.4 months (p=0.03). OS for patients not receiving therapy was 2.7m (vs 7.7m in those treated). Within stage IV OS was shorter for female vs male (4.2 vs 5.8m), and decreased with poorer performance status: 0, 13.5, 1, 8.2m, 2, 3.8m, 3, 2.2m.

      Conclusion:
      Squamous carcinomas are still the second most frequent subgroup of NSCLC. They are more frequently male and almost half of them presented with PS ≥2. Of them, 29% did not even receive CT and out of those treated, only 60% were considered fit to receive a platinum-based therapy. OS was generally poor, but it was remarkably low in patients with PS 2 or worse. Median OS in untreated patients was under 3 months.

  • +

    P2.02 - Poster Session with Presenters Present (ID 462)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Locally Advanced NSCLC
    • Presentations: 1
    • +

      P2.02-016 - Real World Experience with Chemoradiotherapy in Locally Advanced NSCLC (ID 5175)

      14:30 - 14:30  |  Author(s): J. Hernando

      • Abstract

      Background:
      Chemo-radiotherapy (CT-RT) remains the standard therapy for locally advanced Non-Small Cell Lung Cancer (LA NSCLC) . Concurrent therapy is the choice for fit patients, without a proven benefit of either induction or consolidation therapies. However, sometimes, as in our Health system, RT is not readily available from the beginning so CT is started upfront and RT started when possible.

      Methods:
      Charts from every patient treated with CT-RT in our Hospital between January/2008 and December/2015 for LA-NSCLC have been reviewed. Patient and therapy characteristics have been assessed.

      Results:
      184 patients (p) were found: Median age 64 years (41-84), male 151p (82,1%), PS 0/1/2: 34,2/63,6/1,6%. Histology: adenocarcinoma 34,8%, squamous carcinoma 51,8%, NOS 2,7%, NSCLC with neuroendocrine features 10,9%. Stage IIIa 32,1%, IIIb 67,9%. CT included a platinum salt in 98.9% of cases: cisplatin in 57,6% and carboplatin in 41.3%. Most frequent companion drugs were vinorelbine (35.9% overall, 55.7% within patients treated with cisplatin) and paclitaxel (38.0%, 77.6% of those combined with carboplatin). Median number of CT courses was 4 (1-5), and median course when RT was started was third (1-4). Median survival was 22.5 months (18.3-26.7). It was longer in squamous carcinomas (23.1m), male patients (23.3m), stage IIIa (27.5m) and cisplatin-treated (23.5m) although these differences were non-significant. The only significant factor for survival was PS (0= 33.2 m, 1= 19.0m, p<0.001). No differences in patient characteristics existed with respect to stage, gender or histologic subtype between cis- or carboplatin-treated patients. More patients with PS=0 were treated with cisplatin (49/63= 77%) and carboplatin was preferred for PS=1 patients (59/117= 50.4%, p<0.001).

      Conclusion:
      Despite our limitations to start RT early in the treatment of LA-NSCLC our results in real-world clinical practice were comparable to those reported in clinical trials. This was at the cost of increasing the burden of CT up to 4 courses. Probably, proper selection of patients was crucial, with PS 0 patients benefiting most from this approach. No major differences existed according the CT regimen administered (either the use of cis- or carboplatin as backbone or the partner drug used). In our experience, squamous carcinomas remained the most frequent subtype in LA_NSCLC.