Journal Thoracic Oncology

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Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017 mutations significantly increased the success rate from 78.89% to 87.76%. Keywords: Percutaneous lung biopsy, fine needle aspiration, next generation sequencing, Genomic mutation POSTER SESSION 1 - P1.03: RADIOLOGY/STAGING/SCREENING RADIOLOGY – MONDAY, DECEMBER 5, 2016 curves of visual assessment on growth of small pulmonary nodules were 0.975 for observer 1, 0.986 for observer 2, 0.989 for observer 3, and 0.913 for observer 4, respectively. Sensitivities were 96.0% (120/125), 98.4% (123/125), 98.4% (123/125), and 88.0% (110/125), respectively. Specificities were 99.2% (124/125), 99.2% (123/125), 98.4% (124/125), and 96.8% (121/125), respectively. Conclusion: Visual assessment showed high diagnostic performance for determining growth of non-measurable target pulmonary nodules with 20% increase in diameter. Keywords: pulmonary nodule, visual assessment, CT P1.03-015 ASSESSMENT OF RESPONSE OF FDG-PET USING TOTAL LESION GLYCOLYSIS (TLG) IN NSCLC PATIENTS TREATED WITH NIVOLUMAB: RESULTS OF A PILOT STUDY Giulia Fichera 1 , Marco Aiello 1 , Laura Noto 1 , Nunzio Restuccia 1 , Massimo Ippolito 2 , Hector Soto Parra 1 1 Medical Oncology, A.O.U. Policlinico Vittorio Emanuele, Catania/Italy, 2 Azienda Ospedaliera Cannizzaro, Catania/Italy Background: Recent studies using FDG-PET measure the total volumes of the FDG-avid lesions to represent whole-body total metabolic tumor volume (MTV) demonstrating prognostic significance in NSCLC. Total lesion glycolysis (TLG) is the product of mean SUV and MTV and studies have shown the usefulness of TLG for evaluating treatment response. We decide to preliminarily explore the role of TLG, which combines the volumetric and metabolic information of the FDG-PET, as an early predictor of response to nivolumab in NSCLC patients and to determine whether in these patients TLG could provide a better evaluation of response when compared to RECIST. Methods: Between September 2015 and April 2016, we enrolled 15 previously treated advanced NSCLC patients to receive nivolumab 3 mg/kg q2w. The CT-scan and FDG-PET evaluation were performed before starting therapy and after 8 weeks (early evaluation). We compared responses assessed by CT-scan and FDG-PET at 8 weeks according to RECIST 1.1 and TLG parameter respectively. We also performed a CT-scan at 12 weeks to confirm or refute the results of the assessement at 8 weeks. Results: There are no standard cut-offs for the TLG parameter. A ROC curve was used to obtain thresholds for the TLG criteria. The ROC study suggested a TLG value between -76% and +76% to define an SD. We considered a TLG value above +76% to define a PD, while a TLG inferior to -76% was necessary to define a PR. In one patient the evaluation at 8 weeks according to TLG criteria showed PD. The same patient presented SD according to RECIST assessed by CT-scan at 8 weeks. For this patient CT-scan at 12 weeks confirmed PD. In this case the TLG of the FDG-PET early identified the patient’s progression better than CT-scan. In other two patients, TLG criteria assessed at 8 weeks identified a PR in contrast with SD according to RECIST assessed by CT-scan at 8 weeks. CT-scan at 12 weeks confirmed PRs for both these patients. Even in this two cases the evaluation of TLG by FDG-PET early recognized patient’s responses better than CT-scan. For the remaining 12 patients no differences in terms of responses were observed between RECIST and TLG criteria at 8 weeks when compared to RECIST assessed by CT-scan at 12 weeks. Conclusion: These preliminary results from this small study suggest that TLG criteria could provide an early identification of response to nivolumab in NSCLC patients. Keywords: FDG-PET, RECIST, Nivolumab, total lesion glycolysis POSTER SESSION 1 - P1.03: RADIOLOGY/STAGING/SCREENING RADIOLOGY – MONDAY, DECEMBER 5, 2016 P1.03-016 DIAGNOSTIC ACCURACY OF VISUAL ASSESSMENT ON GROWTH OF NON-MEASURABLE TARGET PULMONARY NODULES ACCORDING TO RECIST CRITERIA Jeong Min Ko 1 , Hyun Jin Park 1 , Kyongmin Beck 2 , Dae Hee Han 2 , Hoon-Kyo Kim 1 1 College of Medicine, St. Vincent’S Hospital, the Catholic University of Korea, Suwon-Si/Korea, Republic of, 2 College of Medicine, Seoul St. Mary’s Hospital, the Catholic University of Korea, Seoul/Korea, Republic of Background: Two-dimensional CT measurement considered unreliable in the evaluation of small pulmonary nodule less than 2 cm, and a nodule less than 1 cm in diameter considered non-measurable according to RECIST criteria. The aim of this study was to determine the accuracy of visual assessment on the growth of immeasurable small pulmonary nodules less than 1 cm in diameter on CT. Methods: We selected 125 CT images (1-mm slice thickness axial images, lung window setting, lung algorithm) which have a small pulmonary nodule less than 1cm. Then, we magnified the pulmonary nodules to 120% in diameter using the Photoshop. We coupled these images to 125 sets of ingrowth and growth groups, respectively. Four radiologists with varying experience read these sets to five-point scale using visual assessment (definitely ingrowth, probably ingrowth, possibly growth, probably growth, and definitely growth). Results: The areas under the receiver-operator characteristic POSTER SESSION 1 - P1.03: RADIOLOGY/STAGING/SCREENING RADIOLOGY – MONDAY, DECEMBER 5, 2016 P1.03-017 DOES PET/CT SUVMAX VALUE CORRELATE WITH LONG- TERM SURVIVAL IN PATIENTS WITH SURGICALLY TREATED STAGE I NON-SMALL CELL LUNG CANCER Huseyin Melek 1 , Hasan Kara 2 , Adalet Demir 3 , Gamze Cetinkaya 1 , Akif Turna 2 , Ahmet Sami Bayram 1 , Mehmet Erol 1 , Alper Toker 3 , Kamil Kaynak 2 , Cengiz Gebitekin 1 1 Thoracic Surgery, Uludag University, Bursa/Turkey, 2 Department of Thoracic Surgery, Istanbul University Cerrahpasa Medical School, Istanbul/Turkey, 3 Thoracic Surgery, Istanbul University, Istanbul/Turkey Background: Positron emission tomography (PET/CT), which detects the biologic activity of tumor cells is routinely used in staging of non-small cell lung cancer (NSCLC). However, the role of PET/CT in predicting disease free long-term survival of surgically treated stage I NSCLC is not clear. In this study, we aimed to investigate prognostic value of metabolic uptake (SUVmax) of the tumor in patients with surgically treated stage I NSCLC Methods: Twohundred and sixty patients who had preoperative PET/CT and pulmonary resection for stage I NSCLC between 2005 and 2015 were included into study. The patients were devided into four groups according to the SUVmax value, 0-5, group 1, 5-10 group 2, 10-15 group 3 and over 15 group 4. Lung resection, segmentectomy/lobectomy, was performed within 30 days of PET/CT in all patients. Tumor SUVmax and other potential prognostic variables were chosen for analysis in this study. Patients univariate and multivariate analyses were conducted to identify prognostic factors associated with long-term survival. Results: There were 53 females and 207 males with a mean age of 61,5 (range 20-84). The mean SUVmax value of the tumors in PET/CT was 10,1 (1-48). The type of the lung resection was segmentectomy in 33(12,7%) and lobectomy in 227(87,3%). Pathologic staging of the tumor was stage 1A in 156(60%), and stage 1B in 104(40%). Median follow-up time was 44 months, and overall 5-year survival rate was 81,7% and there was no statistically significant difference between the groups (p=0,3). SUVmax value of the tumor was not effected by age, gender, tumor type and location (peripheral or central)(p>0,05). However, it was found that the SUVmax value significantly increased along with tumor size (p
Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017 Eighty-nine lesions from 13 caucasian EGFR-mutated NSCLC patients treated with TKI were analyzed. Date of progression for each lesion was collected. SUVmax, Metabolic Tumor Volume (MTV), Total Lesion Glycolysis (TLG) were measured on baseline and early follow-up PET/CT performed 2-3 months later. Variations between the 2 PET/CT (ΔSUVmax, ΔMTV, ΔTLG) were calculated. Medians were used as cut-off values for statistical analysis. Risk of progression was analyzed according to PET/CT parameters and Odds Ratios (OR) were calculated. Results: The best metabolic predictors of progression were high SUVmax (>0, i.e. incomplete visual response, OR =9.6, p0, OR=8.3, p0, OR=9.6, p
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LILLY ONCOLOGY IS DEDICATED TO ADVA
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