Virtual Library
Start Your Search
C. Mesia
Author of
-
+
P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
-
+
P2.02-010 - Prognosis Impact of Oligoprogression Following Definitive Chemo-Radiotherapy in Stage III Non-Small Cell Lung Cancer (ID 4456)
14:30 - 14:30 | Author(s): C. Mesia
- Abstract
Background:
The influence of recurrence pattern on outcome in stage III NSCLC following definitive chemo-radiotherapy (CRT) has been scarcely addressed in the literature. Our aim was to analyze the relevance of oligoprogression (OP) in this clinical setting.
Methods:
Patients (pts) with stage III NSCLC who underwent concurrent CRT from 2010 to 2014 at the Catalan Institute of Oncology were retrospectively reviewed (n=170). Recurrence pattern at first progression was recorded. OP was defined as a single metastatic organ with up to 3 lesions. Overall Survival (OS) and Progression-Free Survival (PFS) were plotted using Kaplan Meier method, and multivariate Cox proportional hazards model was developed.
Results:
Median age 64 (37-87); male 87%; ECOG-PS≤1 92%; histology: adenocarcinoma 34%, squamous 43%, NOS+large cell 23%; cN0-1 21%, cN2 60%, cN3 19%. Platinum doublet: cisplatin 62%, carboplatin 38%. RT between 60-70 Gy (2Gy/fr): 94%. At a median follow-up of 38 months (m), 108 of 170 pts relapsed (63%) and 66% died. mPFS was 13m (95% CI 10-16), mOS was 28m (95% CI 22-34). Twenty-five of pts who relapsed (23%) developed OP. Sites involved: visceral 17, brain 4, lymph nodes 3, bone 1. Treatments delivered: local therapy with curative intent 9; palliative intention 12; no treatment 4 (table 1). Among pts who relapsed, mOS was longer in those with OP (32m) compared to pts without OP (18m, p=0.007). Pts with OP who received treatment, mOS according to curative or palliative intention was 53m versus 32m (p=0.1), respectively. In the multivariate Cox analysis of post-progression OS, OP remained a favourable prognostic factor (HR=0.36, 95% CI 0.17-0.74) independently of age, PS, stage, histology, smoking history, and platinum doublet.
Conclusion:
OP was associated with substantial better prognosis in this cohort of pts treated with concurrent CRT. Local ablative therapies in the context of OP yielded promising results in terms of survival and warrants further investigation.
-
+
P2.03b - Poster Session with Presenters Present (ID 465)
- 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)
-
+
P2.03b-044 - Treatment Outcome and the Role of Primary Tumor Therapy in a Cohort of Patients with Synchronous Oligometastatic NSCLC (ID 6089)
14:30 - 14:30 | Author(s): C. Mesia
- Abstract
Background:
Although long-term survival was observed in selected patients (pts) with oligometastatic non-small cell lung cancer, the current treatment for those pts remains controversial. This retrospective study aimed to determine the characteristics and the outcome of pts with synchronous oligometastatic NSCLC (SOM-NSCLC) treated in a single center.
Methods:
SOM was defined as thoracic disease along with ≤3 metastatic lesions. We identified 90 pts in our database that qualified as SOM-NSCLC treated from 2007-2015 at the Catalan Institute of Oncology. Overall Survival (OS) was plotted using Kaplan Meier method, and multivariate Cox model for prognostic factors was developed.
Results:
Pts’ characteristics are shown in Table 1. Most pts received chemotherapy (91%): 85% platinum doublet and 56% ≥4 cycles. 57 of 90 pts (63%) received thoracic radical therapy (TRT): surgical resection (16%), SBRT (3.5%), concurrent chemoradiotherapy (CRT; 70%) and sequential CRT (10.5%). Median OS for all patients was 17.4m (95% CI 9.6 – 25.2). In the multivariate Cox analysis of OS, T extension, histology, smoking history and TRT were independent prognostic factors. As TRT was a highly favourable prognostic factor (HR=0.39, 95% CI 0.20 - 0.80), we looked at the characteristic of pts according to whether they received TRT. Pts treated with TRT had significantly lower number of metastases and metastatic organs involved. 70 of 90 pts (78%) received local therapy (LT) in the metastatic sites: surgery (10%), radiotherapy (61%) or both (29%). Interestingly, pts treated with TRT and LT had significantly longer median OS (32.8; 95% CI 10.8 – 54.9) as compared with other pts (9.3; 95% CI 4.3 – 14.2; p=0.006). Figure 1
Conclusion:
In this retrospective cohort of SOM-NSCLC pts, TRT combined with LT provided a remarkable median OS of 33 months. These data support radical treatment of the primary tumor including definitive chemoradiation in the setting of SOM-NSCLC.
-
+
P3.02b - Poster Session with Presenters Present (ID 494)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
-
+
P3.02b-014 - Monitoring of T790M Mutation in Serum for Prediction of Response to Third Generation Inhibitors (ID 4097)
14:30 - 14:30 | Author(s): C. Mesia
- Abstract
Background:
The emergence of T790M mutation (T790M) represents the main mechanism of acquired resistance (AR) to 1[st] and 2[nd] generation tyrosine kinase inhibitors (TKIs) in EGFR mutant patients (p). Recently, 3[rd] generation inhibitors (T790Mi) have demonstrated activity in EGFR mutant (mu) patients with AR to TKIs harboring T790M. Serum and plasma have been used as an alternative to tissue to detect both sensitizing EGFRmu and T790M. We evaluated if (1) T790M could be monitored along T790Mi therapy in p with baseline T790M in serum, (2) T790M loss could be correlated to clinical and radiographic response, and (3) T790M disappears soon in rapid responders.
Methods:
10 p out of a total of 15 T790M+p treated with T790Mi were selected according the baseline T790M+ in serum. Baseline characteristics, data on changes in T790M in serum; and radiographic and symptom changes along T790Mi therapy were collected. T790M in serum was detected using a PNA-locked nucleic PCR clamp-based technique. T790M was evaluated at baseline and at certain times after T790Mi initiation.
Results:
80% of the p were female and never smoker; 100% were adenocarcinoma, Caucasian, del19, and were treated with previous TKI, with a median (m) time to treatment failure of 11.25 months (mo) [range (r)1-19 mo]. P received 2 previous treatments (r1-6), 40% had a rebiopsy for T790M evaluation, had 3 metastatic sites (r1-6), and had a PS 1 in 70% of the cases. 5 p were evaluable for response with 2 SD and 3 PR as best response (BR) in the 1[st ]evaluation. 7 out of 9 p evaluable for clinical response, experienced an improvement in baseline symptoms as soon as 3 weeks (w) after starting T790Mi, only 1 p experienced an increase in pain, but not related to bone M1. T790M was lost in 80% of the p and it was not detected in serum at 3 or 6 w after the T790Mi initiation in 2 out of 4 and 4 out of 7 evaluable p, respectively.
Conclusion:
T790M detection can be lost early along T790Mi treatment. The decrease in symptom burden is seen in p with loss of T790M. PR and SD represent the BR in p with loss of T790M. The loss of T790M in the serum may be a marker of symptomatic and radiographic response to T790Mi. Future evaluation would demonstrate if the reappearance of T790M mutation in serum could be a marker of resistance to T790Mi.
