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January 2017 Abstracts S681

Background: Bone metastases (BM) are common (up to


50% of cases) in patients with advanced non-small cell P1.06-026
lung cancer (NSCLC) and other malignancies, including Adenosquamous Carcinoma of the Lung:
prostate cancer and breast cancer (BC). In patients with A Single Institution Experience in the
BMs, the onset of skeletal-related events (SREs), such as Era of Molecular Testing
pathological fracture, malignant hypercalcemia, or spinal
cord compression requiring surgery or radiation ther- Topic: Advanced General
apy, seriously affects the quality of life of patients and
overall survival. The purpose of this study was to Kamal Kishore Mandalapu Hematology and Oncology,
analyze the risk factors (RFs) for development of SREs in Merit Health Biloxi., Biloxi/MS/United States of America
women with advanced NSCLC and BC, with the aim of Background: Adenosquamous carcinoma (ADS) lung is
highlighting the differences (if any) between the two rare subtype of non-small cell lung cancer (NSCLC) that
groups of patients. compromises 0.4-4% of all lung cancers and is thought
Methods: The medical records of 16 women with BMs to carry a worse prognosis than adenocarcinoma (AD) or
from NSCLC (Group A) and 15 women with BMs from squamous cell carcinoma (SC). Epidermal growth factor
luminal-type BC (Group B) were reviewed. The following receptor (EGFR) and Anaplastic Lymphoma Kinase (ALK)
RFs have been considered: age >65 years, ECOG per- mutations have been observed in patients (pts) with this
formance status (PS) <2, the presence of extra-skeletal rare subtype. In the recent years EGFR tyrosine kinase
metastases (ESM) or hypercalcemia (>2.65 mmol/L), inhibitors (Gefitinib, Afatinib and Erlotinib) and ALK in-
and number of BMs >1. Odds ratio (OR) estimates and hibitors (Critzotinib, Ceritinib) have prolonged progres-
the relative 95% confidence interval (CI) were calcu- sion free survival in high-stage adenocarcinomas of the
lated. A p-value level <0.05 was considered statistically lung. The current NCCN guidelines recommend EGFR
significant. and ALK mutation testing in metastatic ADS lung cancer
Results: During follow-up, 5 (33.3%) Group A and 111 patients. However the frequency of these mutations as
(68.7%) Group B patients developed SREs (OR¼4.40, well as outcomes of patients with ADS lung is not known
p¼0.04), respectively. The results are reported in the in this era of targeted therapies.
Table. No significant difference (p¼NS) was found be- Methods: We retrospectively identified all pts seen in
tween groups in relation to ECOG-PS, ESM or hypercal- our oncology clinic for ADS during the last 10 years (1/
cemia, and number of BMs. Only the age >65 years 1/2005 - 1/1/2015). Overall survival (OS) was esti-
(OR¼0.22, p¼0.04) represented a weak significant risk mated by Kaplan-Meier methods.
factor. Results: 16 pts were identified, median age at diag-
nosis was 71y (52-85y), 63% male, 81% had a smoking
history, 87% had ECOG performance status 0-1. 37%
Parameter NSCLC BC OR 95% CI p-value
had Stage I, 18% had stage II, 18% had stage III and
No. of patients 15 16 - - - 25% had stage IV disease at diagnosis, 13% developed
Skeletal-related 33.3% 68.7% 4.40 0.97-19.85 0.04
metastatic disease after treatment for stage III disease.
events
Age >65 years 73.3% 37.5% 0.22 0.05-1.01 0.04
75% of pts diagnosed with metastatic disease after
ECOG-Performance 40.0% 18.8% 0.34 0.07-1.76 0.25 2012 were tested for EGFR and ALK, while none
status >2 diagnosed prior to 2012 were tested. All pts were
Extra-skeletal 26.7% 43.7% 2.14 0.47-9.70 0.32 negative for EGFR and ALK mutations. All pts with
metastases Stage I and II received only surgery; pts with stage III
Malignant 26.7% 12.5% 0.39 0.06-2.55 0.39
hypercalcemia
got multimodality treatment with chemotherapy, radi-
Multiple bone 53.5% 37.5% 0.52 0.12-2.20 0.38 ation, and surgery. All the pts with metastatic disease
metastases received chemotherapy, with regimens similar to those
for AD or SC of lung. The median OS for pts with
localized disease was 48.3 months (48.0- NA). The
Conclusion: Women with BMs from NSCLC has a median OS for pts with metastatic disease was 5.4
reduced risk for development of SREs compared to those months (2.3-9.2).
with BC, but elderly (>65 years) patients require a Conclusion: Our small analysis showed that pts with
closer surveillance, and a precocious bisphosphonate localized ADS of lung had similar outcomes to those of
treatment could be suggested. historical pts with localized AD or SC of the lung. How-
Keywords: bone metastases, Skeletal-related events, ever, pts with metastatic ADS of the lung had worse
NSCLC outcomes than historical pts with metastatic AD or SC of
S682 Journal of Thoracic Oncology Vol. 12 No. 1S

the lung even with similar chemotherapy regimens. Few (months) were; RT vs CRT: 8.0 vs 15.5, HR¼0.210 (95%
pts had EGFR and ALK testing, but this is becoming more CI 0.042-1.047), P¼0.057; CRT vs CT: 15.5 vs 14.0,
routine as we have better targeted therapies if they carry HR¼0.206 (95%CI 0.047-0.908), P¼0.037.
mutation. Conclusion: In patients with postoperative local recur-
Keywords: Targeted Therapies, adenosquamous carci- rence of lung cancer, CRT yielded better outcomes than
noma, Anaplastic Lymphoma Kinase (ALK) mutations, the other treatments in terms of PFS.
Epidermal growth factor receptor (EGFR) mutations Keywords: postoperative, recurrence, relapse, local

P1.06-027 P1.06-028
Retrospective Study of Treatment for Description of the Patients with
Postoperative Local Recurrence Advanced Squamous NSCLC Treated
of Lung Cancer in a Single Institution
Topic: Advanced General Topic: Advanced General

Kenjiro Tsuruoka,1 Keiji Miyoshi,2 Irene Torres,1 Joaquín Gimeno,1 Isabel Pajares,1
Ninso Matsunaga,2 Takahiko Nakamura,2 Ana Comin,1 Jorge Hernando,1 Pilar Felices,1
Shuhei Yoshida,2 Yousuke Tamura,2 Ana Nuño,1 Esther Millastre,1 Ana Viñaras,2
Masafumi Imanishi,2 Soichiro Ikeda,2 Angel Artal Cortes1 1Medical Oncology, Hospital
Yasuhito Fujisaka,2 Isao Goto2 1Division of Respiratory Universitario Miguel Servet, Zaragoza/Spain, 2Pharmacy,
Medicine and Thoracic Oncology, Osaka Medical College Hospital Universitario Miguel Servet, Zaragoza/Spain
Hospital, Osaka/Japan, 2Osaka Medical College Hospital,
Background: Squamous carcinomas are a distinct
Osaka/Japan
subtype of NSCLC. Even if it is no longer the most
Background: There is no consensus regarding the frequent one, still remains a significant percentage of
standard treatment for postoperative local recurrence of NSCLC patients in our practice. Besides, clinical pre-
lung cancer. In order to clarify the impact of differences sentation, associated comorbidities and available ther-
in treatment on patient survival, we conducted a retro- apies are different for non-squamous subtypes.
spective study of treatment outcomes for patients with Assessing their characteristics may help to optimize
postoperative local recurrence of lung cancer. therapy.
Methods: The subjects of this study were patients who Methods: Data from patients with a diagnosis of
were diagnosed with postoperative local recurrence of advanced (stage IV patients plus patients with lower
lung cancer and treated at our hospital from 2008 to stages but not amenable for any local therapy) squamous
2014. We divided patients according to treatment NSCLand treated in our Hospital between 2009 and
regimen, and compared patient characteristics and 2015 were reviewed.
survival. Results: 209 patients (p) were found. Median age was
Results: This study included 38 patients. Among them, 8 69 years (40-89). Gender: Male in 89.5%. PS: ECOG
received radiation therapy (RT), 10 received chemo- 0¼ 9.1%, 1¼ 45.9%, 2¼ 38.3%, 3¼ 6.7%. By stage, I¼
radiation therapy (CRT), 18 received chemotherapy (CT), 0.5%, II 3.4%, III 27.7%, IV 68.7%. Therapy: 29.1% of p
and 2 received best supportive care. The patient char- did not receive any systemic therapy and 70.9% receive
acteristics were as follows: median age (range), 71 years chemotherapy (CT). CT included a platinum in 69p
(55e84); gender male/female, 30/8; pStage at operation (carboplatin 47p, cisplatin 22p) and 61p received a non-
IA/IB/IIA/IIB/IIIA/IIIB, 9/6/9/8/5/1; histology small platinum scheme (gemcitabine-vinorelbine 21p, mono-
cell carcinoma/squamous cell carcinoma/adenocarci- therapy 40 p (gemcitabine 8p, oral vinorelbine 23p,
noma, 5/12/21. There were no significant differences in other 9p). Patients with better PS (p<0.001) and stage
patient characteristics between each treatment group. less than IV (0.02) were more probable to receive CT and
The proportion of patients who experienced disease also that CT given included platinum. Overall survival
progression after treatment was 75.0% (6/8) in the RT (OS) was 6.5 months (5.4-7.6) for the whole group. For
group, 20.0% (2/10) in the CRT group, and 77.8% (14/ stage IV patients, it was significantly shorter: 5.4 months
18) in the CT group. Progression free survival (PFS) (p¼0.03). OS for patients not receiving therapy was 2.7m
tended to be better in the CRT group than in the other (vs 7.7m in those treated). Within stage IV OS was
treatment groups. The differences in median PFS shorter for female vs male (4.2 vs 5.8m), and decreased