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T. Nagase
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P2.03 - Chemotherapy/Targeted Therapy (ID 704)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.03-046 - Lymhocyte-To-Monocyte Ratio and Mean Platelet Volume as Prognostic Factor in EGFR Mutant NSCLC Treated with EGFR TKI (ID 9738)
09:30 - 09:30 | Author(s): T. Nagase
- Abstract
Background:
EGFR mutation is a strong predictor of the response to EGFR-TKI, but 10-30% of EGFR-TKI naive patients do not respond to the first line EGFR TKI therapy. Inflammation plays an important role in the initiation, progression, invasion and metastasis of cancer. Recentry study has demonstrated that hematological markers of inflammation such as LMR (lymphocyte to monocyte ratio), RDW (red cell distribution width), and MPV (mean platelet volume) are valuable biomarker in various types of human cancers. The purpose of the present study is to analyze whether hematological markers of inflammation is a prognostic factor in EGFR mutant NSCLC treated with EGFR TKI.
Method:
We retrospectively analyzed 75 advanced or recurrent NSCLC patients with common EGFR mutation treated with EGFR-TKI between 2008 to 2017 at the University of Tokyo hospital. Patients with de novo T790M mutaion, systemic corticosteroids or active infection were excluded from the analysis. We analyzed whether the hematological markers of inflammation before the TKI therapy impact the PFS of TKI therapy. The following variables were included: LMR, RDW, MPV, EGFR mutation subtype (Exon19 deletion of L858R) , ECOG performance status, age and gender. The PFS was estimated by the Kaplan-Meier method and were compared by the log-rank test. Prognostic factors for PFS were assessed by Cox’s proportional hazards regression model. Statiscital analysis was performed using the survival package in the R software.
Result:
Low LMR and high MPV were associated with shoter PFS (log-rank test, p=0.000057 and p=0.03 respectively), but RDW was not associated with PFS. In the multivariate analysis, low LMR (hazard ratio (HR) 2.9; p=0.00015), high MPV (HR 1.7; p=0.039), and poor PS (HR 2.0; p=0.046) were independent risk factors for shoter PFS.
Conclusion:
Low LMR and high MPV are independent risk factors for shorter PFS in patients treated with EGFR-TKI.
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P3.12 - Pulmonology/Endoscopy (ID 728)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Pulmonology/Endoscopy
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.12-004b - All Cause In-Hospital Mortality on Diagnostic Bronchoscopy in Lung Cancer Patients: Data from the Japanese DPC Database (ID 10399)
09:30 - 09:30 | Author(s): T. Nagase
- Abstract
Background:
Due to recent technical advances in bronchoscopy and improvement of molecular targeted therapy, physicians may perform diagnostic bronchoscopy (DB) even in lung cancer patients with poor general status. As for the safety in diagnostic bronchoscopy, there have been little evidence of perioperative mortality, especially in lung cancer patients. We aimed to evaluate the short-term all cause in-hospital mortality not only for adverse events of bronchoscopy, but also for any cause in lung cancer patients who underwent DB.
Method:
We retrospectively collected data of lung cancer patients who underwent bronchoscopy and who were hospitalized between July 2010 and 31 March 2014. Bronchoscopy without taking samples for histology nor cytology, bronchoscopy under mechanical ventilation and therapeutic bronchoscopy were excluded from DB in our study. The primary outcome of this study was all-cause in-hospital mortality within 7 days after DB. We accessed factors, including patients’ ADL (Barthel index) score, comorbidities at admission, and lung cancer staging.
Result:
A total of 77,755 adult lung cancer cases in 954 hospitals underwent DB in inpatient settings. Multivariable logistic regression analysis of factors associated with all-cause mortality within 7 days after DB showed that mortality was associated with sex (adjusted odds ratio (OR); 0.58, (95% CI; 0.44–0.76)), Barthel index score (5.70, 4.48–7.25), lung cancer stage III (3.65, 1.35-9.83)or IV (4.77, 1.89-11.99), Chronic heart failure (2.76, 1.92-1.34), and Interstitial pneumonia (2.58, 1.79-1.24).
Conclusion:
All-cause in-hospital mortality of lung cancer patients after DB were significantly associated with ADL score, lung cancer stage and comorbidities.
