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S. Halil



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    P1.03 - Chemotherapy/Targeted Therapy (ID 689)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Chemotherapy/Targeted Therapy
    • Presentations: 1
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      P1.03-040 - Smokers Having Activating EGFR Mutant Non-Small Cell Lung Cancer Might Benefit from EGFR-TKI Treatment - Single Center Experience (ID 9925)

      09:30 - 09:30  |  Author(s): S. Halil

      • Abstract
      • Slides

      Background:
      Epidermal growth factor receptor (EGFR) mutation is seen 15-20% in non-small cell lung carcinomas (NSCLC), more common in non-smokers, female sex and Asian population. Treating NSCLC patients having activating EGFR mutations with tyrosine kinase inhibitor (TKI) significantly prolongs progression-free survival compared to standard chemotherapy and is a more tolerable. Our aim is to evaluate clinicopathologic features of patients using EGFR directed therapies (erlotinib or gefitinib) longer than 1 year.

      Method:
      Files of 46 patients with metastatic NSCLC having activating EGFR mutations and treated with EGFR TKI between 2012-2017 were retrospectively evaluated. Statistical analysis was done by SPSS 16.

      Result:
      Median age was 61 (30-80), and 56.5% (26/46) was female. Mean follow-up was 38 months.The rate of smoking was 41% (19/46). LDH elevation was found in 67% and CEA elevation was found in 50% of the patients at presentation. Median progression-free survival time (mPFS) was 21 months (range 2-58). mPFS is 21 months (2-35) for patients using erlotinib in first line (35 patients), and 13 months (5-30) in second line setting (11 patients). Sixty four percent of patients had exon 19 deletion, 28% had exon 21 mutation, and 8% had activating exon 18 mutations. There were 27 patients with PFS 12 months or more and 9 patients with less than 12 months. No statistically significant difference was found for PFS when clinicopathologic features (age, gender, 1st or 2nd line usage, LDH or CEA levels, ECOG PS, smoking, weight loss, mutation status) of these patients were compared. Median overall survival time (mOS) for metastatic disease was 39 months (range 4-65). The negative effect of ECOG-PS on OS was shown by univariate and multivariate analysis. Skin toxicity was observed in 18 patients (43%), while treatment was interupted and dose was reduced in 6 patients (14%) due to side effects.

      Conclusion:
      Activating mutation in EGFR is the most important marker that predicts response to EGFR-TKIs in NSCLC. Smokers should be tested for EGFR mutations, as some patients may benefit from EGFR-TKI treatment for longer than reported in the literature.

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    P3.15 - SCLC/Neuroendocrine Tumors (ID 731)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: SCLC/Neuroendocrine Tumors
    • Presentations: 1
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      P3.15-007 - A Retrospective Review of Small Cell Lung Cancer (SCLC) Patients Treated at Marmara University Hospital (ID 10251)

      09:30 - 09:30  |  Author(s): S. Halil

      • Abstract
      • Slides

      Background:
      SCLC accounts for 15%-20% of all lung cancer, and has poor prognosis. The aims of this study were to evaluate the patient characteristics and depict prognostic factors in a series of SCLC patients treated at Marmara University Hospital (MUH) Istanbul.

      Method:
      Among SCLC patients who were admitted to MUH since 01 January 2010, 154 had satisfactory data to analyse. Demographic data, pathology & radiology reports, lab investigations, information regarding local & systemic therapies were noted from written & electronic patient records. Patient and tumour characteristics were reported descriptively. OS difference between subgroups were analysed with Log-rank & factors that had independent effect on survival detected with Cox regression tests. OS data were calculated with Kaplan-Meier estimator. A p value <.05 was accepted as significant unless reported otherwise.

      Result:
      The median follow-up time was 17 (min-max; 3-84) months. Median survival time of all patients was 10 months; 1 year, 2 & 3 years survival rates were 41%, 22%, and 12%, respectively. Median survival of patients with limited stage and extension stage SCLC were; 22,6 Ms (9,9-35,3), and 9 Ms (7,2-10,8), respectively. On univariate analysis patient with low initial serum haemoglobin (<12 gr/dl), abnormal sodium or ALT (> 40 IU/l) levels, poor ECOG PS (2-3), advanced VA stage, having brain, liver, bone or adrenal mets, and having a paraneoplastic syndrome (PNS) had worse survival estimates. Whereas only ECOG PS (p=0.007, HR 2.2 [1.2-4]), and having a PNS (p=0.04, HR 1.66 [1.02-2.7]) maintained independent prognostic effect on survival in Cox analysis.

      Conclusion:
      Results of our small retrospective SCLC series showed that median survival of extensive stage SCLC patients is poor (< 1 year) which underlies the need of novel anticancer therapeutics for this group of patients. Our multivariate model pointed out well known prognostic factors but not the VA stage. This may be explained with the small population size of our study.

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