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T. Kovacevic
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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-075 - PD-1 Protein Expression Predicts Survival in Resected Adenocarcinomas of the Lung (ID 5641)
14:30 - 14:30 | Author(s): T. Kovacevic
- Abstract
Background:
Immune checkpoint inhibitors targeting programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1) have demonstrated clinical activity in patients with advanced non-small cell lung carcinoma (NSCLC). The ability of PD-1 and PD-L1 immunohistochemistry (IHC) to predict benefit of immune checkpoint inhibitors remains controversial. We assessed the prognostic value of PD-1 and PD-L1 IHC in patients with completely resected adenocarcinoma of the lung.
Methods:
We determined protein expression of PD-1 and PD-L1 in formalin-fixed paraffin-embedded surgical specimens of 161 NSCLC patients with adenocarcinoma histology by IHC. We used the EH33 antibody (Cell Signaling) for PD-1 and the E1L3N antibody (Cell Signaling) for PD-L1 IHC. Cut-points of ≥1% PD-1-positive immune cells at any staining intensity and ≥1% PD-L1-positive tumor cells at any staining intensity were correlated with clinicopathological features and patient survival.
Results:
Positive PD-1 immunostaining in immune cells was observed in 71 of 159 (45%) evaluable tumor samples. PD-1 positive staining was not significantly associated with any of the clinicopathological features. Positive PD-1 immunostaining was associated with longer recurrence-free and overall survival of the patients. Multivariate Cox proportional hazards regression analyses identified PD-1 to be an independent prognostic factor for recurrence (adjusted hazard ratio [HR] for recurrence 0.58; 95% confidence interval [CI] 0.36 to 0.94; P = 0.026) and death (adjusted HR for death 0.46; 95% CI 0.26 to 0.82; P = 0.008). PD-L1 positive staining in tumor cells was seen in 59 of 161 (37%) cases. Positive PD-L1 immunostaining correlated with KRAS mutation (P = 0.019) and type of surgery (P = 0.01) but was not significantly associated with any of the other clinicopathological parameters. Positive PD-L1 immunostaining was not associated with survival of the patients (adjusted HR for recurrence 0.92; 95% CI 0.58 to 1.47; P = 0.733; adjusted HR for death 0.61; 95% CI 0.34 to 1.07; P = 0.084).
Conclusion:
Positive PD-1 but not PD-L1 immunostaining is a favorable independent prognostic factor in patients with completely resected adenocarcinoma of the lung.
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P3.05 - Poster Session with Presenters Present (ID 475)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Palliative Care/Ethics
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.05-011 - Importance of Assessment of Malnutrition Risk in Lung Cancer Patients (ID 5944)
14:30 - 14:30 | Author(s): T. Kovacevic
- Abstract
Background:
Malnutrition and cachexia are commonly seen in cancer patients. The aim of this research was to assess overall risk of malnutrition in lung cancer patients.
Methods:
This prospective observational study that included hospitalized lung cancer patients was conducted in the Institute for pulmonary diseases of Vojvodina, Serbia. International questionnaire for nutrition screening was used for clinical assessment of malnutrition. Subjects were included in this study regardless of lung cancer type, stage of disease and therapy regiment.
Results:
Out of total 188 patients included, 76.1% were male and 23.9% female. Majority of patients were in ECOG performance status (PS) 1 (74.5%) with diagnosed lung cancer in stages III and IV (39.9% and 42.6% respectively). Most common lung cancer type was adenocarcinoma (50.0%) followed by sqamous (35.6%), small-cell (10.6) and other hystologic types (3.7%). Majority of patients had Body Mass Index (BMI) >20 (87.8%). BMI<18 was observed in 7.4% of patients. Unplanned weight loss in past 3-6 months for more than 10% was present in 16.5% of patients. In this group of patients 20.7% were with high risk, 12.8% with medium risk and 66.5% with low risk of malnutrition. High risk of malnutrition was more frequent in stages III and IV of lung cancer (24.0% and 22.5% respectively) than in stages I and II (13.3% and 5.6% respectively). We observed statistically significant correlation between ECOG PS and risk of malnutrition (p=0.001; ρ=0.240). Patients with ECOG PS 0 are ten times less likely to have high risk of malnutrition than patients with poorer ECOG PS.
Conclusion:
This study showed that a significant percentage of lung cancer patient have a high risk of malnutrition therefore it would be advisable to routinely evaluate nutritional status of lung cancer patients regardless of stages and duration of disease.
