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A. Rebic
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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)
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P2.03b-009 - Brain Metastasis and Epidermal Growth Factor Receptor Mutations in Croatian Caucasians with Lung Adenocarcinoma (ID 5182)
14:30 - 14:30 | Author(s): A. Rebic
- Abstract
Background:
The brain is a common site of metastasis in non-small cell lung cancer (NSCLC). The aim of this study was two-fold: 1) to determine the incidence of brain metastasis (BM) in Caucasian lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutations and 2) to evaluate the frequencies and potential relationship of the different EGFR mutations with BM.
Methods:
A retrospective cohort study was conducted at a Croatian tertiary hospital (Clinic for Respiratory Diseases “Jordanovac”) using data collected from medical records. Caucasian patients with primary NSCLC who were tested for EGFR mutation status between January 2014 and October 2015 were included.
Results:
Of 1040 NSCLC samples tested, 122 (11.7%) patients with lung adenocarcinoma harboured EGFR mutations; six EGFR positive (+) patients (four with BM) had repeat EGFR testing. The majority of EGFR mutants were females (n= 90, 77.6%), non-smokers (including never-smokers and former-smokers; n= 95, 92.2%), diagnosed with advanced disease (stage IIIB/IV) at first presentation (n= 75, 68.8%), and median age at initial diagnosis of primary lung cancer was 65 years (35 - 90). Twenty-three (19.8%) of 116 EGFR+ patients were diagnosed with BM; for six EGFR+ patients, data about BM was missing. Most were 64 years of age or younger (n= 15, 65.2%) at diagnosis of BM (median age: 62 years, 48 - 72). Synchronous BM disease at initial diagnosis of lung cancer was found in 43.5% of EGFR+ patients with BM (n= 10). There were more EGFR+ women with BM (n= 20, 87%) than men. Single exon 19 deletion and exon 21 L858R mutations were the most common subtypes in both EGFR+ patients without BM (n= 44, 47.3% and n= 27, 27.8%, respectively) and with BM (n= 13, 56.5% and n= 5, 21.7%, respectively). One BM patient (4.3%) had a double mutation (exon 19 and 21), while six non-BM patients (6.2%) had simultaneous pairings, most commonly between exon 19 and 20 (n=3, 3.1%). Although exon 18 mutations were seen in six patients without BM (6.2%), none were found in BM+EGFR+ patients. Exon 20 T790M mutation occurred in 17.4% of BM patients (n= 4) versus 15.3% of non-BM patients (n= 15). Rare EGFR double mutations (exon 18 and 20) were found in two non-BM patients (2.2%).
Conclusion:
Larger long-term prospective studies to explore and confirm these results in BM+EGFR+ patients are warranted. In the era of precision oncology, molecular testing of EGFR mutations may further clarify the pathogenesis of lung cancer-associated BM.
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P3.02c - Poster Session with Presenters Present (ID 472)
- 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)
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P3.02c-019 - The Use of Metformin and the Incidence of Metastases at the Time of Diagnosis in Patients with Lung Cancer and Type 2 Diabetes (ID 6116)
14:30 - 14:30 | Author(s): A. Rebic
- Abstract
Background:
Lung cancer is often insidious disease. It usually produces only a few symptoms until the disease is advanced. At initial diagnosis 20% of patients have localized disease, 25% of patients have regional metastasis and 55% of patients have distant spread of disease. Metastasis is a process by which a small number of cancer cells undergo numerous alterations, which enables them to form secondary tumors at another and often multiple sites in the host. Recently, studies have suggested that cancer stem cells are the originators of metastasis. Cancer stem cells are small populations of slowly dividing, tretment – resistant , undifferentiated cancer cells that are being discovered in a different cancers. Metformin has proved to be effective in the treatment of glioblastomas and neuroblastomas, in vitro, by targeting their cancer stem cell population. Recently, studies have shown that metformin use is not associated with a decreased risk of lung cancer in patients with type 2 diabetes, but it has been suggested that metformin use is associated with improved survival among patients with stage IV NSCLC patients.
Methods:
The aim of our study was to compare incidence of metastasis in lung cancer patients (NSCLC and SCLC) that were treated with metformin and patients with lung cancer that were not treated with metformin. It is a retrospective analysis of lung cancer patients diagnosed at our department between January 1, 2012 and December 31 2013. and data were collected from our computerized base.
Results:
During the two-year period in our department there were 335 newly diagnosed lung cancer patients. Among them there were 25 (7%) patients with diabetes mellitus that were on therapy with metformin prior to lung cancer diagnosis for at least six months. We have proved significant difference between two groups in the incidence of patients with distant spread of disease (stage IV) at the time of diagnosis. Metformin group had a lower inicidence of stage IV at the time of diagnosis ( 44% vs 64%; x2 =4.14; p=0.041). The results did neither revealed a significant difference in total number of patients with distant spread nor in the type of metastasis.
Conclusion:
We have shown that patients that were treated with metformin had lower incidenece of distant metastases at the time of diagnosis. Further research should evaluate biologic mechanisms and test the effect of metformin on inhibiting the cancer spread in prospective clinical trials.
