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K.K. Mandalapu
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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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P1.06-026 - Adenosquamous Carcinoma of the Lung: A Single Institution Experience in the Era of Molecular Testing (ID 6103)
14:30 - 14:30 | Author(s): K.K. Mandalapu
- Abstract
Background:
Adenosquamous carcinoma (ADS) lung is rare subtype of non-small cell lung cancer (NSCLC) that compromises 0.4-4% of all lung cancers and is thought to carry a worse prognosis than adenocarcinoma (AD) or squamous cell carcinoma (SC). Epidermal growth factor receptor (EGFR) and Anaplastic Lymphoma Kinase (ALK) mutations have been observed in patients (pts) with this rare subtype. In the recent years EGFR tyrosine kinase inhibitors (Gefitinib, Afatinib and Erlotinib) and ALK inhibitors (Critzotinib, Ceritinib) have prolonged progression free survival in high-stage adenocarcinomas of the lung. The current NCCN guidelines recommend EGFR and ALK mutation testing in metastatic ADS lung cancer patients. However the frequency of these mutations as well as outcomes of patients with ADS lung is not known in this era of targeted therapies
Methods:
We retrospectively identified all pts seen in our oncology clinic for ADS during the last 10 years (1/1/2005 - 1/1/2015). Overall survival (OS) was estimated by Kaplan-Meier methods
Results:
16 pts were identified, median age at diagnosis was 71y (52-85y), 63% male, 81% had a smoking history, 87% had ECOG performance status 0-1. 37% had Stage I, 18% had stage II, 18% had stage III and 25% had stage IV disease at diagnosis, 13% developed metastatic disease after treatment for stage III disease. 75% of pts diagnosed with metastatic disease after 2012 were tested for EGFR and ALK, while none diagnosed prior to 2012 were tested. All pts were negative for EGFR and ALK mutations. All pts with Stage I and II received only surgery; pts with stage III got multimodality treatment with chemotherapy, radiation, and surgery. All the pts with metastatic disease received chemotherapy, with regimens similar to those for AD or SC of lung. The median OS for pts with localized disease was 48.3 months (48.0- NA). The median OS for pts with metastatic disease was 5.4 months (2.3-9.2)
Conclusion:
Our small analysis showed that pts with localized ADS of lung had similar outcomes to those of historical pts with localized AD or SC of the lung. However, pts with metastatic ADS of the lung had worse outcomes than historical pts with metastatic AD or SC of the lung even with similar chemotherapy regimens. Few pts had EGFR and ALK testing, but this is becoming more routine as we have better targeted therapies if they carry mutation
