Study KBP-2010-CPHG: Characteristics and management of 7,051 new cases of lung cancer managed in French general hospitals in 2010.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1574-1574
Author(s):  
Chrystele Locher ◽  
Dominique Herman ◽  
Geoffroy De Faverge ◽  
Hubert Barbieux ◽  
Christine Lemonnier ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Epidemiologic Study ◽  
Primary Lung Cancer ◽  
Stage Iv ◽  
Patient Characteristics ◽  
New Drugs ◽  
First Line ◽  
Multi Centre Study ◽  
General Hospitals ◽  
Cancer Management

1574 Background: An initial epidemiologic study was performed in 2000 by the French College of General Hospital Respiratory Physicians (Study KBP-2000-CPHG). Over the last 10 years, lung cancer management changed: new drugs such as targeted therapies appeared; new diagnostic techniques such as exploration for genetic mutations in the tumour have been developed; a new TNM classification has been drawn up. The aims of this study were to describe patient characteristics, first-line management, 1, 4 and 5-year survival rates and to compare the results with those of Study KBP-2000-CPHG. Methods: A prospective multi-centre study included all patients ≥18 years presenting with a new case of primary lung cancer, histologically or cytologically diagnosed between 1 January and 31 December 2010 and managed by one of the participating centers. A standardised form was completed for each patient. A steering committee checked the exhaustivity of data’s collection. Results: 7,610 patients from 119 general hospitals were included between 1 January and 31 December 2010. The main patient characteristics were: mean age 65.5 years (+/-11.3); 24.3% female; 10.9% non-smokers, 39.9% ex-smokers, 49.2% current smokers; 68.9% performance status 0 and 1; 9.1% of patients had lost >10 kg within the previous 3 months. The main tumour characteristics were: 13.7% small-cell lung cancer; 46.2% adenocarcinoma, 26.8% squamous-cell carcinoma; EGFR mutation, explored in 30.5% of cases, were found in 10.5% of cases; 16.4% stage IA to IIB, 13.4% stage IIIA, 10.2% stage IIIB and 60.0% stage IV. First-line treatments were: curative surgery, 16.6%; chemotherapy, 63.4%; radiotherapy alone, 17.8%; combined radio-chemotherapy, 8.8%; and supportive care, 11.1%. Targeted therapy was used in 6.6% of patients treated by chemotherapy. Conclusions: In 10 years, characteristics of lung cancer patients changed with an significantly increase of women, non-smokers, adenocarcinoma histology and stage IV at diagnosis.

266 Tumour mutation burden (TMB) and efficacy outcomes in the phase III DANUBE study of advanced urothelial carcinoma (UC)

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A292-A292
Author(s):  
Sophie Wildsmith ◽  
Jill Walker ◽  
Anne L’Hernault ◽  
Weimin Li ◽  
Hannah Bye ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Stage Iv ◽  
Small Cell ◽  
Phase Iii ◽  
Survival Outcomes ◽  
Line Treatment ◽  
Small Cell Lung ◽  
First Line ◽  
Unresectable Stage ◽  
First Line Treatment

BackgroundThe phase III DANUBE study assessed the efficacy of the PD-L1 inhibitor durvalumab (D), alone or in combination with the CTLA-4 inhibitor tremelimumab (T), versus standard of care chemotherapy (SoC) for the first-line treatment of unresectable, locally advanced or metastatic UC. The study did not meet its co-primary endpoints of improving overall survival (OS) for D monotherapy vs SoC in patients with high tumor PD-L1 expression or for D+T vs SoC in the intention-to-treat population.1 TMB measurement in blood (bTMB) or tumour (tTMB) has been linked to improved efficacy with PD-1/PD-L1 inhibitors in UC and with D+T in non-small cell lung cancer,2 thus providing a rationale to explore TMB in the DANUBE trial.MethodsBaseline plasma samples from DANUBE were assessed for bTMB using the Guardant OMNI platform, while baseline tTMB was measured in formalin-fixed paraffin-embedded (FFPE) tumour samples using the FoundationOne CDx gene panel. Associations between progression-free survival (PFS) and median and landmark OS with bTMB and tTMB levels at various cutoffs were assessed as part of a pre-specified exploratory analysis. The data cutoff occurred on January 27, 2020.ResultsAmong 1032 patients randomised in DANUBE, 536 (51.9%) were evaluable for bTMB and 623 (60.4%) were evaluable for tTMB. For D vs SoC, bTMB and tTMB were not associated with OS or PFS at any cutoff. For D+T, stronger associations between bTMB and OS as well as PFS were observed with increasing bTMB cutoffs (table 1). At the bTMB cutoff ≥ 24 mut/Mb, 12-month OS rates were 76.7% for D+T and 54.3% for SoC, whereas for bTMB < 24 mut/Mb, 12-month OS rates were 53.4% for D+T and 51.2% for SoC. Similar trends for both OS and PFS were observed with tTMB (table 1).Abstract 266 Table 1Association between TMB and survival outcomes with D+TAssociation between TMB and survival outcomes with D+TConclusionsBoth bTMB and tTMB are potentially useful biomarkers for enriching responses to D+T in previously untreated, advanced UC. Neither bTMB nor tTMB was associated with better outcomes for D monotherapy. Cutoffs of 24 mut/Mb for bTMB and 10 mut/Mb for tTMB appear optimal for D+T in the setting of previously untreated, advanced UC.Trial RegistrationThe trial is registered with ClinicalTrials.gov, NCT02516241, and the EU Clinical Trials Register, EudraCT number 2015-001633-24.ReferencesAstraZeneca. Update on phase III DANUBE trial for IMFINZI and tremelimumab in unresectable, stage IV bladder cancer [press release] March 6, 2020. [https://www.astrazeneca.com/media-centre/press-releases/2020/update-on-phase-iii-danube-trial-for-imfinzi-and-tremelimumab-in-unresectable-stage-iv-bladder-cancer-06032020.html]Rizvi NA, Cho BC, Reinmuth N, et al. Durvalumab with or without tremelimumab vs standard chemotherapy in first-line treatment of metastatic non-small cell lung cancer: The MYSTIC phase 3 randomized clinical trial. JAMA Oncol. 2020:6:661–674.Ethics ApprovalThe study protocol was approved by the Ethics Board at each investigator’s institution.

First-line systemic treatment with gefitinib in stage IV non-small cell lung cancer

2005 ◽  
Author(s):  
Tobias Lange ◽  
Carsten Müller-Tidow ◽  
Hubert Serve ◽  
Petra Hoffknecht ◽  
Wolfgang Berdel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Treatment ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line

Diagnosis and First-Line Treatment of Patients with Lung Cancer in Italian General Hospitals

1989 ◽  
Vol 75 (2) ◽  
pp. 163-167 ◽  
Author(s):  
◽  
Alexan Alexanian ◽  
Giovanni Apolone ◽  
Roldano Fossati Roberto Grilli ◽  
Paola Mosconi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell ◽  
Disease Stage ◽  
Diagnostic Process ◽  
Line Treatment ◽  
First Line ◽  
General Hospitals ◽  
Diagnostic Time ◽  
First Line Treatment

The quality of diagnostic and therapeutic care was examined in a series of 380 consecutive newly diagnosed cases of primary lung cancer seen in 20 Italian general hospitals between January and June 1987. At diagnosis most patients (78%) had one or more symptoms related to the tumor, and in an additional 9 % symptoms were related to the presence of distant metastases. The median diagnostic time lag between first symptoms and final diagnosis was 50 days with a significantly longer delay in patients first seen by their general practitioner compared with those who sought first care in hospital outpatient departments. The diagnostic process was satisfactorily carried out in fewer than two-thirds of the patients leading to complete ascertainment of disease stage and histology in 58% cases with significantly better performance in more specialized institutions. Analysis of the first-line treatment profile indicated a rather aggressive therapeutic attitude In the case of patients with non-small cell lung cancer – 28% of them had chemotherapy despite the lack of any proof of efficacy in controlled clinical trials – and a failure to identify among the patients with small cell disease those amenable to more aggressive treatment. The lack of progress in the treatment of lung cancer over the last decades seems to have resulted in widely varying practice patterns where a mixture of aggressive and laissez-faire attitudes does not take into account that in the absence of effective therapies a more conservative attitude would at least have some advantage in terms of quality of remaining life for many patients.

Clinical characteristics, diagnosis, treatment, and prognosis in lung cancer patients under the age of 45.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17508-e17508
Author(s):  
Nektaria Makrilia ◽  
Alexios S Strimpakos ◽  
Ioannis Gkiozos ◽  
Kostas N Syrigos
Keyword(s):  
Lung Cancer ◽  
Chronic Hepatitis ◽  
Performance Status ◽  
Young Patients ◽  
Primary Lung Cancer ◽  
Stage Iv ◽  
Great Loss ◽  
Female Ratio ◽  
Lung Cancer Patients ◽  
Tertiary Center

e17508 Background: Lung cancer remains uncommon among young adults but it causes great loss of life expectancy in this age group. The definition of young age varies in the published studies from 40 to 50 years of age. Methods: Our aim was to assess whether patients diagnosed at young ages have unique clinicopathological and prognostic characteristics. We retrospectively reviewed records of patients aged 45 or younger who were treated for primary lung cancer at a large tertiary center between June 2003 and June 2011. Results: 2,651 patients with lung cancer were screened of whom 73 (2.8%) were aged ≤45. The male-to-female ratio was 1.6:1 and the median age at diagnosis was 42. 89% of patients were smokers. Performance status (PS) was 0, 1 and 2 in 61%, 29% and 10% of patients, respectively. The most common histological types were adenocarcinoma (47%), small-cell lung cancer (SCLC) (18%) and squamous cell carcinoma (18%). The median time elapsing between beginning of symptoms and diagnosis was 3 months. Chronic hepatitis B or C was mentioned in the medical history of 5/13 (38%) SCLC patients, whereas it was present in 4/60 NSCLC patients under 45 (p=0.008) and in 16/518 SCLC patients over the age of 45 (p<0.0001). Patients were diagnosed with stages I, II, III and IV in 2 (3%), 11 (18%), 13 (22%) and 34 (57%) of NSCLC cases, respectively, whereas 7 of 13 (54%) SCLC patients were diagnosed with limited disease. The median overall survival was 21 months and multivariate analysis indicated that PS and time until diagnosis were independent prognostic factors. Conclusions: Although more than half of young patients are at stage IV when diagnosed, prognosis does not seem as dismal as previously considered. Larger studies need to be conducted in order to elucidate the possible role of chronic hepatitis in the pathogenesis of SCLC in young patients.

Study KBP-2010-CPHG: Characteristics and management of 968 new cases of small-cell lung cancer (SCLC).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19078-e19078
Author(s):  
Charles Dayen ◽  
Daniel Coëtmeur ◽  
Celine Lecerf ◽  
Adrien Diximier ◽  
Bertrand Lemaire ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Primary Lung Cancer ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
Curative Surgery ◽  
Platinum Based Chemotherapy

e19078 Background: In recent years, many major advances have been made in non-small-cell lung cancer (NSCLC), and in particular in adenocarcinoma, but not in SCLC. In 2010, the French College of General Hospital Respiratory Physicians (CPHG) performed a prospective multicentre epidemiological study (KBP-2010-CPHG) to describe the baseline characteristics and management of all new cases of primary lung cancer and to evaluate survival. The present abstract reports results in SCLC patients. Methods: 7,051 patients ≥18 years presenting with a new case of primary lung cancer, histologically or cytologically diagnosed between 1 January and 31 December 2010 and managed in the respiratory department of one of the 104 general hospitals participating in the study, were included. A standardised form was completed for each patient. A steering committee checked data collection exhaustiveness. SCLC data were analysed separately. Results: There were 968 SCLC patients: mean age, 65.6 years (+/-10.6); 23.2% female; 4.4% non-smokers (11 % in women), 35.8% ex-smokers, 59.8% current smokers; 63.4% with performance status 0 or 1; 59.9% having lost weight within the previous 3 months (19.8% of whom had lost >10 kg). Main tumour characteristics at diagnosis were: 71.2% stage IV, 24.7% stage IIIA or IIIB, 4.1% of stage <III. 15.2% of patients received chemo-radiotherapy and 73.4% chemotherapy (86.2% platinum-based). Carboplatin was more commonly used in patients >70 (59.1%) than <70 years of age (40.9 %). One-year mortality was 64.2%. Compared with NSCLC patients, patients with SCLC more frequently were active smokers (59.8% vs.47.6%), lost weight (59.9% vs. 52.4%), and presented with stage IV tumour at diagnosis (71.2% vs. 58.3%); first line therapy was more frequently platinum-based chemotherapy (86.2% vs. 61.2%) and less frequently curative surgery (1.6% vs. 19%), and mortality was higher (64.2% vs. 55.2%). Conclusions: In 2010, prognosis remains poor in SCLC. Compared with NSCLC, it was more frequently associated with active smoking and stage IV disease, and showed a lower rate of surgery.

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