Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
patients diagnosed with cancer at our department between January 1, 2012
and December 31, 2014, with special focus on pulmonary neuroendocrine
tumors. We examined incidence of different histologic types of pulmonary
neuroendocrine tumors and sorted out patients with diagnosis of largecell
neuroendocrine carcinoma. We also analysed clinical characteristics of
patients with LCNEC. Results: During the three-years period 1242 pulmonary
patients were admitted to our department. Among them there were 726
newely diagnosed cancer patients. Various types of lung cancer were found
in 652 patients. There were 104 patients with pulmonary neuroendocrine
tumors, what makes about 16%. Thirteen of them (2%) were „pure“ LCNEC,
16 (2,5%) mixed LCNEC with small-cell component, 68 SCLC (10%), 4
atypical carcinoid, 2 typical carcinoid and 1 typical carcinoid in patient with
adenocarcinoma. Generally in our patients high-grade neuroendocrine tumors
make about 15%, and low-grade neuroendocrine tumors (carcinoides) make
only 1% of all lung cancers. Most patients diagnosed with LCNEC were men
over 50 years, heavy smokers, which is consistent with published data, but
one patient was a 40-year-old woman. Conclusion: Pulmonary neuroendocrine
tumors are group of neoplasms classified into four categories based on
their patohistology. Three of them (carcinoides and LCNEC) are rare tumors.
LCNEC is type of neuroendocrine tumor with most diagnostic and therapeutic
difficulties. Clinical features of our patients are similar to previously
published, while incidence is slightly lower.
Keywords: LCNEC, lung cancer, Neuroendocrine tumors
POSTER SESSION 1 - P1.07: SCLC/NEUROENDOCRINE TUMORS
SCLC/NEUROENDOCRINE TUMORS IN GENERAL –
MONDAY, DECEMBER 5, 2016
P1.07-052 PULMONARY NEUROENDOCRINE TUMORS: SINGLE
INSTITUTION EXPERIENCE IN BRAZIL
Renata Rosenthal 1 , Maria Teresa Tsukazan 2 , Álvaro Vigo 2 , Flávio Cabral 1 ,
Arthur Vieira 1 , Gabriel Schwarcke 1 , Jayme Rios 1 , José Antonio Pinto 1 , Vinícius
Duval Da Silva 1
1 Hospital São Lucas Da Pucrs Porto, Porto Alegre/Brazil, 2 Universidade Federal Do
Rio Grande Do Sul - Ufrgs, Porto Alegre/Brazil
Background: The primary lung neuroendocrine tumors (NET) are uncommon.
They have a wide spectrum of clinical behavior, currently being classified into
four types: tumor typical carcinoid (low grade malignancy), atypical carcinoid
(intermediate malignancy grade), neuroendocrine large cells carcinoma and
small cells. Neuroendocrine lung tumors represent a large and heterogenic
group with different management and survival rates. Little information
regarding neuroendocrine tumors is available for Latin American countries.
Methods: Retrospective service database review of patients with NET treated
at Hospital São Lucas in Porto Alegre, Brazil between 1991-2015. Inclusion
criteria were age 18 or older with histologically or immunochemistry
confirmed neuroendocrine tumor. For analysis purposes we divided between,
typical carcinoid, atypical carcinoid and poorly differentiated (large and small
cells). Results: From January of 1991 to December of 2015, of 946 lung cancer
resections 49 patients with NET were resected. Most the patients were
female (57,1%), mean age 55 years (28- 84 years). Typical carcinoid represented
63,3% of patients, followed by atypical carcinoid (22,4%) and poorly
differentiated neuroendocrine tumors (14,3%). Mean age was 51,4 for typical
carcinoid, 56 for atypical carcinoid and 63 for undifferentiated NET.
Lobectomy was the surgical approach for 85,7%, pneumonectomy was
required for 4,1% and segmentectomy for 10,2% of patients. Minimally
invasive (VATS) was done in 4,1%.
Conclusion: According to the European Consensus, pulmonary carcinoids
account for 1–2% of all invasive lung malignancies. We found 85,7% of our lung
resections were carcinoids and a higher mean age 51,4 for patients with
typical and 56 for atypical carcinoids compared to the literature.
Keywords: Pulmonary Neuroendocrine tumors, Carcinoids, large cells
carcinoma, Small cells
POSTER SESSION 1 - P1.07: SCLC/NEUROENDOCRINE TUMORS
SCLC/NEUROENDOCRINE TUMORS IN GENERAL –
MONDAY, DECEMBER 5, 2016
P1.07-053 APATINIB FOR CHEMOTHERAPY-REFRACTORY
EXTENSIVE STAGE SCLC: RESULTS FROM A SINGLE-CENTER
RETROSPECTIVE STUDY
Wei Hong, Hui Li, Xiangyu Jin, Xun Shi
Zhejiang Cancer Hospital, Hangzhou/China
Background: It has no standard treatment strategy for patients with
extensive stage small cell lung cancer (SCLC) who experienced progression
with three or more lines of chemotherapy. Apatinib, a new tyrosine kinase
inhibitor targeting vascular endothelial growth factor receptor 2(VEGFR-2),
has been shown confirming antitumor activity and manageable toxicities in
breast and gastric cancers. Until now, couples of clinical trials investigating
the efficacy of apatinib on non-small cell lung cancer are ongoing. However,
the effects of apatinib on small cell lung cancer are still unclear. We
retrospectively assessed the efficacy and safety of apatinib in patients with
extensive-stage small cell lung cancers after the failure of second or third-line
chemotherapy. Methods: The study group comprised 13 patients who received
oral apatinib, at a dose of 500 mg daily, for progression after the failure of
second or third-line chemotherapy for extensive-stage small cell lung cancer.
Treatment was continued until disease progression. For the patients who had
grade 3 or 4 toxicities, the dose of apatinib was decreased to 250mg daily. The
patients stopped the treatment if they still had the unacceptable toxicity
after dose downregulation. We analyzed safety and response (RECIST 1.1) for
the available patients monthly. Results: Between Aug 30, 2015 and May 1,
2016, 13 patients were enrolled. In 13 patients, there were 11 patients available
for efficacy and safety evaluation. 5/11 (45.5%) patients experienced dose
reduction during treatment. Followed up to July 20, 2016, the median during
time of afatinib treatment was 2.8 months (95% confidence interval (CI),
1.67-5.04). According to RECIST criteria, the disease control rate was 81.8%,
9/11 (partial response 18.2%, 2/11 and stable disease 63.6%, 7/11). The most
frequent treatment-related adverse events were secondary hypertension
(45.5%, 5/11), oral mucositis (27.3%, 3/11), hand-foot syndrome (27.3%, 3/11)
and fatigue (27.3%, 3/11). Main grade 3 or 4 toxicities were hypertension
(27.3%, 3/11), oral mucositis (9.1%, 1/11) and fatigue (9.1%, 1/11). Conclusion:
Apatinib exhibits modest activity and acceptable toxicity for the heavily
pretreated patients with extensive-stage small cell lung cancer.
Keywords: SCLC, Apatinib
POSTER SESSION 1 - P1.07: SCLC/NEUROENDOCRINE TUMORS
SCLC/NEUROENDOCRINE TUMORS IN GENERAL –
MONDAY, DECEMBER 5, 2016
P1.07-054 SECOND PRIMARY SMALL CELL CARCINOMA OF LUNG IN
PREVIOUSLY TREATED CARCINOMA BREAST
Prasanta Mohapatra 1 , Pritinanda Mishra 2 , Manoj Panigrahi 1 , Gourahari
Pradhan 1 , Sourin Bhuniya 1 , Susama Patra 2 , Madhabananda Kar 3
1 Pulmonary Medicine, All India Institute of Medical Sciences, Bhubaneswar/India,
2 Pathology, All India Institute of Medical Sciences, Bhubaneswar/India, 3 Surgical
Oncology, All India Institute of Medical Sciences, Bhubaneswar/India
Background: Breast cancer is the major cause of cancer among women
worldwide. Some of the patients are treated with surgery followed by
adjuvant chemotherapy and radiation therapy. It is presumed that the
radiation of surrounding tissues during breast radiotherapy may cause
cancer in other areas of body. Methods: A 40 year old woman presented with
chest pain and breathing difficulties for four months. She was diagnosed
as infiltrating duct cell carcinoma of right breast and undergone modified
radical mastectomy. Her 1 of 20 lymph nodes showed tumour metastases
with perinodal extension. Triple marker (oestrogen receptor, progesterone
receptor, her 2 neu receptor) was negative. She was given four cycles of CEF
regimen cyclophosphamide,epirubicin,5-FU) and four cycles of paclitaxel.
She had also received 25 fraction of radiotherapy completed over one year
before. There was no other co-morbid conditions, family history was not
significant. She had average body built and nutrition. On general examination
mild pallor was only positive finding, no peripheral lymphadenopathy or
clubbing. Contrast enhanced computed tomogram of chest revealed bilateral
lung nodular infiltrates more predominantly in left lower lobe, mediastinal
lymphadenopathy with left lower lobe collapse. Ultrasound abdomen
detected no significant abnormality. Bronchoscopy showed multiple nodules
present over carina, infiltration in right lower lobe segmental opening,
left main bronchus lumen narrowed due to diffuse infiltrative growth. The
endobrochial biopsies were taken from this area. Results: Endobronchial
biopsy revealed tumour cells were strongly and diffusely positive for
synaptophysin and negative for chromogranin and TTF1 . The diagnosis of
small cell carcinoma lung was made. MRI of brain showed ring enhancing
lesions in right cerebellar hemisphere suggestive of metastases. Staging
Copyright © 2016 by the International Association for the Study of Lung Cancer
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