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J. Liang
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P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.02-003 - Increased Circulating Cytokeratin-19 (Cyfra 21-1) is Predictive of Poor Outcome of Locally Advanced Squamous Cell Carcinoma in Lung (ID 4344)
14:30 - 14:30 | Author(s): J. Liang
- Abstract
Background:
Our goal was to evaluate the prognostic significance of circulating tumour markers in locally advanced squamous cell carcinoma of lung (LA-SCCL).
Methods:
Eligible patients included those with histologically proven LA-SCCL, available baseline tumour marker panel analysis (carcino-embryonic antigen [CEA], carcinoma antigen 125 [CA125], squamous cell carcinoma antigen [SCC], cytokeratin-19 [Cyfra 21-1] and neuron-specific enolase [NSE]) and receiving definitive radiotherapy. Age, gender, radiation dose, baseline KPS, smoking history, weightless, TNM stage, PET staging, RT technique and treatment modality (radiotherapy alone vs. sequential chemoradiotherapy vs. concurrent chemoradiotherapy) were also retrospectively collected. To dichotomise the continuous values of tumour markers into categorical variables, ROC analysis was adopted to identify the optimal cutoff values using the progression within 2 years after diagnosis as the endpoint. Cox regression based multivariate analyses were used to select independent factors correlated with various survival endpoints. Overall survival (OS), local regional progression free survival (LRPFS) and distant metastasis free survival (DMFS) were defined as the time from diagnosis until the first occurrence of specific event: death, local-regional recurrence or distant metastasis, respectively. Progression free survival (PFS) was defined as the duration between the cancer diagnosis and the date of any progression or cancer related death.
Results:
A total of 216 patients with LA-SCCL were analyzed. The optimal discriminative values for CEA, CA125, SCC, Cyfra 21-1 and NSE in predicting 2-y progression were 5.3 ng/ml, 17.0 U/ml, 2.5 ng/ml, 5.2 ng/ml and 17.8 ng/ml, respectively. Univariate analyses showed that increased Cyfra 21-1 was associated with inferior OS, LRPFS, DMFS and PFS. Increased NSE was predictive of poor OS, DMFS and PFS. CEA also presented significant correlation with OS. Under multivariate analysis involving all clinical and tumour markers, IIIA stage, better performance status, CEA ≤ 5.3 ng/ml and Cyfra 21-1 ≤ 5.2 ng/ml were independently associated with improved OS. IMRT technique, RT dose ≥ 60Gy and Cyfra 21-1 ≤ 5.2 ng/ml were correlated with better LRPFS. None-smoker, IIIA stage, NES ≤ 17.8 ng/ml were favourable predictors for DMFS. IIIA stage, KPS ≥ 80 and Cyfra 21-1 ≤ 5.2 ng/ml were advantageous factors related with favourable PFS.
Conclusion:
Baseline tumour marker panel including Cyfra 21-1, NSE and CEA can be prognostic of OS, local and distant tumor control for LA-SCCL, and should be recommended for baseline evaluation of tumour burden.
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P2.02-025 - Continuous Intravenous Pumping Endostar Combined with Radiochemotherapy in Unresectable Stage Ⅲ Non-Small-Cell Lung Cancer (ID 3909)
14:30 - 14:30 | Author(s): J. Liang
- Abstract
Background:
Preclinical models have shown that recombinant human endostatin(Endostar) can transiently normalize the tumor vasculature to make it more efficient for oxygen delivery, which provides a treatment window of enhancing tumor radiosensitivity. This study is to evaluate the safety and efficacy of continuous intravenous pumping(CIP) of Endostar combined with standard concurrent radiochemotherapy for unresectable stage Ⅲ non-small-cell lung cancer(NSCLC).
Methods:
In this prospective study, patients with unresectable stage Ⅲ~A~ or Ⅲ~B~ NSCLC received CIP of Endostar (7.5mg/m[2]) over 5 days at week 1, 3, 5, and 7. During week 2-8, patients received two 28-day cycles of etoposide 50mg/m[2] on day 1-5 and cisplatin 50mg/m[2] on day 1, 8, with concurrent thoracic radiation of 60-66 Gy in 30-33 fractions over 6-7 weeks. Acute toxicities were evaluated using CTCAE 3.0. Tumor response was evaluated using RECIST 1.1 criteria.
Results:
Between Nov. 2012 and May. 2016, 67 patients were eligible for toxicity and efficacy evaluation, including 56(83.6%) male and 11(16.4%) female, 44(65.7%) with squamous cell carcinoma, 20(29.9%) with adenocarcinoma, 1(1.5%) with large cell carcinoma and 2(3.0%) with undifferentiated carcinoma, and 28(41.8%) with stageⅢA disease and 39(58.2%) with ⅢB disease, respectively. The median age was 59(31-69) years. All patients completed the treatment as planned, except that 3 patient missed one cycle chemotherapy. There were 8(11.9%), 43(64.2%), 11(16.4%) and 4(6.0%) patients achieved complete response, partial response, stable disease and progressive disease, respectively. The objective remission rate (ORR) is 76.1%. There were 23 patients (34.3%) with grade 3+4 neutropenia, 9(13.4%) with grade 3+4 anemia, and 10(14.9%) with grade 3+4 thrombocytopenic. Three patients (4.5%) developed grade 3 nausea/vomiting. Grade 3 acute esophagitis, grade 1+2 and grade 3 pneumonitis were observed in 8(11.9%), 12(17.9%) and 2 (3.0%) patients，respectively. One patient died of pneumonitis before efficacy evaluation. No grade 2 cardiovascular toxicity was observed．Up to the last follow-up, the med
Conclusion:
For patients with unresectable stageⅢ NSCLC, CIP of Endostar enhanced patient compliance, and combined with concurrent radiochemotherapy is tolerable and the short term outcomes are promising. Long term survival data wait further follow up．
