Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
SC16: SUPERIOR SULCUS TUMORS
TUESDAY, DECEMBER 6, 2016 - 14:30-15:45
SC16.04 INDIVIDUALIZED EXTENDED LUNG CANCER SURGERY: THE
CHINESE EXPERIENCE
Qinghua Zhou
Medical Oncology, Shanghai Pulmonary Hospital, Tongji University, Shanghai/
China
Backgroud: Lung cancer is the leading cause of cancer deaths in the world.
For patients with advanced non-small cell lung cancer (NSCLC), survival
prognosis is very poor with chemotherapy and radiotherapy. However, the
possibility of occult metastases may lead to discrepancy between clinical
and pathologic staging and underestimation of the disease severity, and
how to individualized choose the appropriate patients with locally advanced
non-small cell lung cancer for surgery is controversies. In this study, we
presented here the Chinese experience: individual precision surgery for locally
advanced non-small cell lung cancer based on molecular staging. Methods:
We developed several molecular biomarkers and molecular models from
Circulation Tumor Cell (CTC ) detection, mi-RNA chip, Gene Chip from 1990.
We used these Molecular biomarkers and molecular models for molecular
staging, molecular typing, choosing indication of operation and neoadjuvant
chemotherapy, predicting postoperative recurrence and prognosis of locally
advanced non-small cell lung cancer. Results: We developed two molecular
staging model for individualized surgical treatment for locally advanced
non-small cell lung cancer involving heart, great vessels or both. 3308 patients
with locally advanced non-small cell lung cancer were underwent completely
resection of the cancer in the three medical center. The 1-, 3-, 5- and 10 year
survival rate were 74.5%,62.3%,31.5% and 22.9%, respectively. We used our
molecular staging model for neoadjuvant chemotherapy for 665 patients
with locally advanced lung cancer. The 1-, 3-, 5- and 10-year survival rate were
79.35%, 51.46%, 27.39% and 20.34% of the patients, respectively. We used our
molecular model to divide N2 lung cancer into invasive N2 and Non-invasive
N2 group. We used our molecular models adenocarcinoma and squamous
carcinoma to divide T4 lung cancer into high recurrence and low recurrence
groups, and help postoperative adjuvant therapy. Conclusion: Our molecular
staging and typing models can help us carry out individual precision surgery,
predicting prognosis and cancer recurrence of the cancer for locally advancer
no-small cell lung cancer. Keywords: non-small cell lung cancer, individual
precision surgery, Molecular staging, molecular typing
for 1st line chemotherapy (CT). ORR was 20-25% for platinum-duplets,
1-year survival – 27,5-37,5 month. The 1-year survival showed best results
in absolute figures with paclitaxel and platinum compounds in SCC and
gemcitabine and platinum compounds in non-SCC, but the value was not
statistically significant neither for 1-year nor for median survival. For SCLC
new combination with irinotecan and platinum compound showed ORR –
55,1% and stabilization of disease in 24,3% of pts. Conclusions: Nowadays the
treatment approaches to lung cancer in Russia depends from morphological
type of tumors, IGC results and needs further investigations. Keywords:
NSCLC, NET, Squamous cell carcinoma, Adenocarcinoma, lung cancer
SC17: LUNG CANCER: A GLOBAL CANCER WITH DIFFERENT REGIONAL CHALLENGES
TUESDAY, DECEMBER 6, 2016 - 14:30-15:45
SC17.02 LUNG CANCER IN CHINA: CHALLENGES AND PERSPECTIVES
Li Zhang
Medical Oncoloyg Dept., Sun Yat-Sen University Cancer Center, Guangzhou/China
Lung cancer is still the leading cause of cancer death in China. The estimated
new lung cancer cases and deaths were 733,300 and 610,200 in 2015,
respectively. Non-small cell lung cancer (NSCLC) remains the predominant
form of the disease in China, with majority of patients being diagnosed at
advanced stages. Thus this presentation will focus on advanced stage NSCLC.
Current treatment strategy The current treatment algorithm for wild-type
non-squamous and squamous NSCLC were shown in Figure 1 and 2,
respectively.
SESSION SC17: LUNG CANCER: A GLOBAL CANCER WITH
DIFFERENT REGIONAL CHALLENGES
TUESDAY, DECEMBER 6, 2016 - 14:30-15:45
Figure 1. Treatment algorithm for non-squamous NSCLC (wild-type)
SC17.01 LUNG CANCER IN RUSSIA: CHALLENGES AND
PERSPECTIVES
Vera Gorbunova
Russian Oncological Research Center, Institution of Russian Academy of Medical
Science, Moscow/Russian Federation
Background: Cancer is set to become a major cause of morbidity and
mortality in coming decade in every region of the world. Methods: The
mortality, morbidity and treatment variants in Russia were evaluated.
Results: The incidence of lung cancer morbidity in Russia in 2014 numbered
57 685, mortality – 49 730. Standardized index incidence rate demonstrates
improvement of men since year 2009. It was 55,0 on 100 000 population in
2009; 49,15 in 2013 and 49,0 in 2014. It means a 10,9% decrease since 2009 to
2014. It takes stable first place in men.
In women the same years showed different values: 7,0; 7,17; 7,3 at 2009, 2013
and 2014 years respectively, that means + 4,3%. It takes 10-12 places of all
malignant diseases among women. Among men lung cancer is on the first
place (26,6%) in mortality rates. A non-interventional, prospective cohort
study included 838 patients, average age 58,7; male – 78,4%; female – 21,6%,
smokers – 26,5%; ex-smokers – 24,1%, current smokers – 49,4%. Disease stages
at diagnosis were: stage I-II – 36,8%; stage III – 37,8%; stage IV – 25,4%. It was
squamous-cell carcinoma – 54,3%; adenocarcinoma – 31%; BAR – 6,4%; LCC –
2,9%, adenosquamous carcinoma – 2,3%, other – 3,1%.
Proportion of EGFR positive tumors constitutes 10,1% (85/838) pts. Surgery
was performed for 393 pts (46,9%). Radiotherapy was administered to 145
pts (17,8%). 370 pts (44,2%) underwent first-line CT and 96 (11,8%) – secondline.
The treatment depends on the morphology type of the tumor. We
consider four main types NSCLC (AdenoCa and SCC), LCLC and NETs. NETs
group included typical and atypical carcinoids, LCNEC, SCLC. We participated
in 53 different multicenter international trials in lung cancer, including 930
patients. Outside of these protocols we analyzed 567 pts with advanced
NSCLC: 255 pts with squamous cell cancer (SCC) and 250 pts with non-SCC
Figure 2. Treatment algorithm for advanced squamous NSCLC
For patients with activating EGFR mutations, EGFR-TKIs therapy will
be used as front-line therapy. Commercial available EGFR-TKIs in China
include Gefitinib, Erlotinib and Icotinib. For patients harbouring an ALK
rearrangement, crizotinib will also be considered as first-line treatment.
When failed from EGFR-TKIs or ALK-Inhibitor therapy, patients will be
treated according to clinical model of disease progression. For patients
with asymptomatic progression, continuing EGFR-TKIs or ALK-Inhibitor
is recommended. For patients with local progression, EGFR-TKIs or ALK-
Inhibitor will also be continued with additional local therapy such as whole
brain radiation. However, for patients with aggressive progression, EGFR-TKIs
or ALK-Inhibitor will be substituted by chemotherapy. Unfortunately, it is
difficult to overcome drug resistance according to molecular mechanism
because novel agents such as Osimertinib and Alectinib haven’t been
approved by Chinese FDA. Challenge and perspective 1. Genetic alterations
assays Genetic alterations are frequent in Chinese NSCLC patients.
According to PIONEER study (NCT01185314), which is a prospective molecular
Copyright © 2016 by the International Association for the Study of Lung Cancer
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