A Case of Small Cell Cancer of the Breast in a Male with Synchronous Stage IV Non-Small Cell Lung Carcinoma

9061 Background: To treat LCNEC with non-small cell lung carcinoma type chemotherapy (NSCLC-ct, i.e. gemcitabine/taxanes or pemetrexed) or small cell lung carcinoma type (SCLC-ct, i.e. platinum-etoposide) is subject of debate. Molecular studies have identified two mutually exclusive subtypes in LCNEC, the co-mutated TP53 and RB1and the STK11/ KEAP1 (predominantly RB1 wildtype(wt)) group. We investigated if overall survival (OS) and progression free survival (PFS) correlates with targeted next-generation sequencing (TNGS) results in LCNEC treated with NSCLC-ct or SCLC-ct. Methods: For this population based retrospective cohort study all diagnoses of stage IV ct treated high grade neuroendocrine carcinomas (NEC, not being SCLC) were retrieved from the Netherlands Cancer Registry and Pathology Registry (PALGA) (2003-2012). Panel-consensus pathology revision of original tumor slides was performed on (N = 230) and TNGS for genes TP53, RB1, STK11 and KEAP1 analyzed with a multi-sample variant caller (Needlestack). Results: LCNEC was consensus diagnosed in 146/230 and 77 passed quality control for TNGS. Mean coverage was 2832x, a mutation(mt) in TP53 was present in 87%, RB1mt in 46%, STK11mt in 13% and KEAP1mt in 18% of sequenced LCNEC. RB1 was co-altered with TP53 in 94% of LCNEC; mutually exclusive to STK11mt (100%) but not KEAP1mt (57%). NSCLC-ct or SCLC-ct was specified in 92% of patients and RB1wt LCNEC treated with NSCLC-ct (n = 22) showed a trend to better OS compared to SCLC-ct (n = 13) (8.5 months (95% confidence interval (CI): [6.3-10.6]) vs. 5.8 [5.5-6.1] months, p = 0.055). Due to reported resistance in NECs we analyzed NSCLC-ct without pemetrexed-ct; OS was significantly longer for NSCLC-ct (n = 15) compared to SCLC-ct (9.6 [7.7-11.6] vs. 5.8 [5.5-6.1] months, p = 0.026). PFS of RB1wt NSCLC-ct treated patients was significantly longer than SCLC-ct (p = 0.044), without pemetrexed (p = 0.018). In patients with RB1mt LCNEC OS/PFS was not significantly different for NSCLC-ct vs. SCLC-ct. Conclusions: In LCNEC with RB1wt, NSCLC-ct correlates with a more favorable outcome compared to SCLC-ct. However, RB1mt LCNEC treated with NSCLC-ct do similarly worse as SCLC-ct. Prospective studies should be initiated.

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Clinical research platform into molecular testing, treatment and outcome of non-small cell lung carcinoma Patients (CRISP): A prospective German registry in stage IV NSCLC, AIO-TRK-0315

Annals of Oncology ◽

10.1093/annonc/mdx091.045 ◽

2017 ◽

Vol 28 ◽

pp. ii44-ii45

Author(s):

F. Griesinger ◽

W. Eberhardt ◽

N. Marschner ◽

M. Jänicke ◽

A. Fleitz ◽

...

Keyword(s):

Clinical Research ◽

Lung Carcinoma ◽

Small Cell Lung Carcinoma ◽

Stage Iv ◽

Small Cell ◽

Molecular Testing ◽

Small Cell Lung ◽

Cell Lung Carcinoma ◽

Research Platform ◽

German Registry

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Clinical response to chemotherapy in non-small cell lung carcinoma patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195531 ◽

2019 ◽

Vol 7 (12) ◽

pp. 4641

Author(s):

Ravi Kiran Narukurthi ◽

Nallamothu Murali Krishna ◽

Jetty Mounika ◽

T. Jaya Chandra

Keyword(s):

Partial Response ◽

Lung Carcinoma ◽

Small Cell Lung Carcinoma ◽

Stage Iv ◽

Small Cell ◽

Stage Iii ◽

Clinical Staging ◽

Small Cell Lung ◽

Cell Lung Carcinoma ◽

Response To Chemotherapy

Background: Lung carcinoma is the most common. With this, a study was conducted to assess the clinical profile of Non-small cell lung carcinoma (NSCLC) and also to evaluate the response to chemotherapy in various stages of NSCLC.Methods: It was a prospective study. All the clinically confirmed cases with NSCLC were taken into consideration. Clinical staging was done, diagnosis was confirmed by histopathological findings. Treatment was given depending on the stage of carcinoma. Patients were evaluated before each cycle of chemotherapy for any progression of disease. Pathological response was evaluated after completion of 6 cycles of chemotherapy. Chi square test was used to find the statistical significance; p<0.05 was considered statistically significant.Results: Total 153 patients admitted to oncology wing were taken to the study, with mean age 59.07±10.618 years, 2.6 male female ratio. In this 73% were in stage III and the remaining in stage IV NSCLC. Majority (56.10%) of the study subjects in stage III NSCLC showed partial response, Majority (68%) of the subjects in stage IV NSCLC showed partial response; the difference was Statistically significant (p<0.05).Conclusions: NSCLS is common in older people with male dominance due to habits.

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