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F. Mazza
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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
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.06-025 - Analysis of Risk Factors for Development of Skeletal-Related Events in Women with Bone Metastases from NSCLC and Breast Cancer (ID 4933)
14:30 - 14:30 | Author(s): F. Mazza
- Abstract
Background:
Bone metastasis (BM) are common (up to 50% of cases) in patients with advanced non-small cell lung cancer (NSCLC) and other malignancies, including prostate cancer and breast cancer (BC). In patients with BMs, the onset of skeletal-related events (SREs), such as pathological fracture, malignant hypercalcemia, or spinal cord compression requiring surgery or radiation therapy, seriously affects the quality of life of patients and overall survival. The purpose of this study was to analyze the risk factors (RFs) for development of SREs in women with advanced NSCLC and BC, with the aim of highlighting the differences (if any) between the two groups of patients.
Methods:
The medical records of 16 women with BMs from NSCLC (Group A) and 15 women with BMs from luminal-type BC (Group B) were reviewed. The following RFs have been considered: age >65 years, ECOG performance status (PS) <2, the presence of extra-skeletal metastases (ESM) or hypercalcemia (>2.65 mmol/L), and number of BMs >1. Odds ratio (OR) estimates and the relative 95% confidence interval (CI) were calculated. A p-value level <0.05 was considered statistically significant.
Results:
During follow-up, 5 (33.3%) Group A and 111 (68.7%) Group B patients developed SREs (OR=4.40, p=0.04), respectively. The results are reported in the Table. No significant difference (p=NS) was found between groups in relation to ECOG-PS, ESM or hypercalcemia, and number of BMs. Only the age >65 years (OR=0.22, p=0.04) represented a weak significant risk factor.Parameter NSCLC BC OR 95% CI p-value No. of patients 15 16 - - - Skeletal-related events 33.3% 68.7% 4.40 0.97-19.85 0.04 Age >65 years 73.3% 37.5% 0.22 0.05-1.01 0.04 ECOG-Performance status >2 40.0% 18.8% 0.34 0.07-1.76 0.25 Extra-skeletal metastases 26.7% 43.7% 2.14 0.47-9.70 0.32 Malignant hypercalcemia 26.7% 12.5% 0.39 0.06-2.55 0.39 Multiple bone metastases 53.5% 37.5% 0.52 0.12-2.20 0.38
Conclusion:
Women with BMs from NSCLC has a reduced risk for development of SREs compared to those with BC, but elderly (>65 years) patients require a closer surveillance, and a precocious bisphosphonate treatment could be suggested.
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P2.03a - Poster Session with Presenters Present (ID 464)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03a-031 - Metronomic Oral Vinorelbine as First-Line Treatment in Elderly (>65 Year) Patients with Advanced NSCLC (ID 4769)
14:30 - 14:30 | Author(s): F. Mazza
- Abstract
Background:
Non-small cell lung cancer (NSCLC) is one of the most frequent malignancies, and the majority of diagnosis are made at an advanced stage (IIIB/IV), with unsatisfactory results. Vinorelbine is a microtubule-targeting agent, with a favorable safety profile, and is currently available also as oral chemotherapeutic agent. Metronomic chemotherapy (MCT) is an attractive strategy for treating cancer, which has been shown to reduce toxicities and to extend duration of treatment, resulting in lower resistances and prolonged survival rates. The aim of our study was to evaluate the role of oral metronomic vinorelbine (mVNR) as first-line treatment in population of elderly unfit-platin patients with advanced NSCLC.
Methods:
Twenty patients (13 men and 7 women, median age 78 years, range 66-88) with advanced NSCLC (3 patients stage IIIb, 17 patients stage IV) and a median of 4 major co-morbidities, non-oncogenic addicted and unfit for platin, were treated with oral mVNR as first-line treatment, at a dose of 40 mg (Group 1, 9 patients) or 50 mg (Group 2, 11 patients) as MCT on days Monday, Wednesday and Friday. The ECOG performance status was 1 (PS1) in 11 patients and 2 or 3 (PS2-3) in 9.
Results:
The median overall survival (OS) was 7.80 months (PS1: 11.27 months; PS2-3: 4.3 months) and time-to-progression (TTP) was 3.07 months (PS1: 3.0 months; PS2-3: 3.5 months). The median OS in Group 1 was 4.5 months and 9.4 months in Group 2. Best response showed stable disease in 5 cases, partial response in 4, progression disease in 7. Low toxicity was reported because grade 1-2 asthenia was the most frequently reported symptom.
Conclusion:
Metronomic chemotherapy is a new approach that combines good tolerability and acceptable activity. Our preliminary data suggest that oral mVNR in advanced NSCLC may be an effective first-line treatment, even in elderly and unfit patients with major co-morbidities.
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P3.03 - Poster Session with Presenters Present (ID 473)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.03-022 - Serum CEA, VEGF and MMP-7 in Patients with Malignant Pleural Effusion. A Prospective Study with Logistic Regression Analysis of Accuracy (ID 5427)
14:30 - 14:30 | Author(s): F. Mazza
- Abstract
Background:
Several tumor markers have been proposed in differentiating between benign and malignant pleural effusions (PE). The aim of this prospective study was to evaluate the usefulness of serum carcinoembryonic antigen (CEA), vascular endothelial growth factor (VEGF), and matrix metalloproteinase-7 (MMP-7) assay in patients with PE of uncertain origin.
Methods:
A series of 36 consecutive patients with suspicious PE requiring VATS-guided biopsy underwent serum CEA, VEGF, MMP-7 measurement before PC and biopsy. There were 20 (55.6%) males and 16 (44.4%) females, with an overall median age of 67 (range 40-82 years). According to the receiver operating characteristic (ROC) curve, the optimum cutoff levels were 5 ng/mL, 7.5 ng/mL, and 250 pg/mL for CEA, VEGF and MMP-7, respectively.
Results:
Final pathology showed 10 (27.8%) patients with NSCLC, 13 (36.1%) with LMs, and 13 (36.1%) with benign PE. The age did not differ between groups (p=0.59). The sensitivity, specificity and accuracy of PC were 56.5%, 92.3%, and 69.4%, respectively. The results of serum markers measurement are reported in the Table (95% CI). The logistic regression excluded CEA from the model, and thus we calculated the area under the curve (AUC) of the combination VEGF+MMP-7. The AUC was 0.681 (95% CI: 0.413-0.743) and the diagnostic accuracy was 77.8%, which was superior than that of MMP-7 alone (72.2%, p=0.41). Figure 1
Conclusion:
In patients with PEs, the measurement of serum VEGF and MMP-7 together reached a good accuracy with a fair AUC, and should be suggested when a noninvasive evaluation of a PE is required.
