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A.A. Ansari



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

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P1.06-011 - Altered Body Composition and Fat Loss in Advanced Non-Small Cell Lung Cancer (ID 4212)

      14:30 - 14:30  |  Author(s): A.A. Ansari

      • Abstract

      Background:
      Assessment of body composition, including fat mass and fat%, is a useful measure of nutritional status in cancer and may help guide nutritional interventions. However, these abnormalities have not been well documented in lung cancer. We aimed to study alterations in parameters of body composition in Non small cell lung cancer (NSCLC).

      Methods:
      A retrospective chart review was conducted of all newly diagnosed patients with NSCLC. Age and sex matched healthy controls were recruited prospectively. Disease staging was done according to the American Joint Committee on Cancer (7th edition). Performance status was asssessed using the Karnofsky performance Scale(KPS), and the Eastern Cooperative Oncology Group (ECOG). Details of body composition including basal Metabolic Rate (BMR), total body water (TBW), fat mass, and Fat-free mass (FFM) were calculated by bioelectric impedance method using TANITA TBF 300 body composition analyzer.

      Results:
      A total of 256 patients (83.6% males) and 211 controls (81.5% males) were studied. The mean (SD) age of patients was 54.5(9.0) years, median smoking index was 598 (range, 0-2500) and mean duration of symptoms was 158.3(91.7) days. Median KPS was 80 (range, 40-100). Majority had Stage IV disease (54.7%), followed by Stage III (41.4%) and Stage II (3.9%). All measured components of body composition were significantly lower in NSCLC compared to controls (Table).Among patients with normal body weight (BMI 18.5 – 25 kg/m[2]), the TBW and FFM were significantly lower compared to their healthy counterparts. Figure 1



      Conclusion:
      NSCLC is associated with significant malnutrition and altered body composition, especially reduction in the percentage of body fat. Nutritional interventions must, therefore, be tailored accordingly for these patients.

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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
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      P3.02b-037 - Does Tissue EGFR Mutation Status Predict Treatment Response and Mortality in Adenocarcinoma Lung? (ID 4836)

      14:30 - 14:30  |  Author(s): A.A. Ansari

      • Abstract

      Background:
      Targeted therapy with tyrosine kinase inhibitors (TKI) in EGFR positive patients is associated with superior response rates in Caucasian and East Asian populations. Whether similar response is observed in Asian Indians with lung cancer is not yet clear. We aimed to compare the response rates and survival between EGFR positive and negative patients with advanced adenocarcinoma lung at a tertiary level centre in North India.

      Methods:
      Treatment naive patients of adenocarcinoma lung were recruited. All patients underwent complete staging and tissue EGFR mutation analysis using DNA extraction and Polymerase chain reaction. EGFR positive patients were treated with oral Gefitinib 250 mg once daily and EGFR negative patients with 3-weekly cycles of platinum based doublet chemotherapy. Treatment response was evaluated after 3 months of Gefitinib or after 4 cycles of chemotherapy using CT-PET scan and categorized as Complete metabolic remission (CR), partial response (PR), stable disease (SD), and progressive disease (PD). The proportion of responders (CR + PR) and non-responders (SD+PD), and short term survival at 3 months were compared between EGFR positive and negative patients.

      Results:
      59 patients completed response evaluation at 3 months / 4 cycles. These included 41 males (59.5%), with a mean (SD) age 55.9 (11.2) years. Majority (89.4%) had metastatic stage IV disease. 34 patients (67.5%) were current or previous smokers, with median smoking index of 400 (range, 0-1500). 76% patients had KPS of 80 or above, and 78% had ECOG of 0-1. Overall, 17 patients (29.3%) were tissue EGFR positive for either of exons 18, 19, or 21. The 3-month outcomes in EGFR positive and negative groups were: complete response – 1.6% vs 0 %, partial response - 61 % vs 24.4%, stable disease – 5.6% vs 26.8%, progressive disease – 11.1% vs 17.1%, and mortality in 16.7% vs 31.7% respectively. EGFR positive group had higher responders compared to EGFR negative patients (p=0.002) although mortality rate did not differ significantly.

      Conclusion:
      EGFR mutation positive patients treated upfront with TKI are more likely to show objective response at three months and demonstrate a trend towards lower mortality compared to EGFR negative patients treated with conventional chemotherapy.