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non-small cell lung cancer, early stage<br />

1179O THE EUROPEAN THORACIC ONCOLOGY PLATFORM<br />

LUNGSCAPE PROJECT: A WAY TO BRIDGE NON-SMALL<br />

CELL LUNG CANCER MOLECULAR CHARACTERISTICS<br />

AND CLINICAL DATA<br />

S. Peters 1 , O. Dafni 2 , L. Bubendorf 3 , P. Meldgaard 4 ,K.O’Byrne 5 , A. Wrona 6 ,<br />

W. Weder 7 , M. Canela 8 , S. Malatesta 9 , J. Vansteenkiste 10 , A-M. Dingemans 11 ,<br />

M. Nicolson 12 , S. Savic 13 , P. Baas 14 , R. Peck 15 ,S.Lu 16 ,E.Smit 17 ,<br />

E. Jantus-Lewintre 18 , R. Rosell 19 , R.A. Stahel 20<br />

1 Multidisciplinary Oncology Center, Lausanne Cancer Center, Centre Hospitalier<br />

Universitaire Vaudois, Lausanne, SWITZERLAND, 2 Frontier Science<br />

Foundation-Hellas, A<strong>the</strong>ns, GREECE, 3 Division of Cytology, Institute for<br />

Pathology, University Hospital Basel, Basel, SWITZERLAND, 4 Department of<br />

Oncology, Aarhus University Hospital, Aarhus, DENMARK, 5 HOPE Directorate,<br />

St James’s Hospital, Dublin, IRELAND, 6 Department of Oncology and<br />

Radio<strong>the</strong>rapy, Medical University of Gdansk, Gdansk, POLAND, 7 Division of<br />

Thoracic Surgery, University Hospital Zurich, Zurich, SWITZERLAND, 8 Surgery,<br />

Vall d’Hebron University Hospital, Barcelona, SPAIN, 9 Anatomia Patologica,<br />

Ospedale Clinicizzato, Chieti, ITALY, 10 Respiratory Oncology, University Hospital<br />

Leuven, Leuven, BELGIUM, 11 Pulmonology, Maastricht University Medical<br />

Centre, Maastricht, NETHERLANDS, 12 Medical Oncology, Aberdeen Royal<br />

Infirmary, Aberdeen, UNITED KINGDOM, 13 Pathology, Institute for Pathology,<br />

University Hospital Basel, Basel, SWITZERLAND, 14 Department of Thoracic<br />

Oncology, The Ne<strong>the</strong>rlands Cancer Institute, Amsterdam, NETHERLANDS,<br />

15 University Hospital South Manchester and The Christie NHS Foundation Trust,<br />

Manchester, UNITED KINGDOM, 16 Shanghai Lung Tumor Clinic Center,<br />

Shanghai Chest Hospital, Shanghai, CHINA, 17 Pulmonology, Vrije Universiteit<br />

Medical Center, Amsterdam, NETHERLANDS, 18 Fundación para la Investigación<br />

del Hospital General Universitario de Valencia, Valencia, SPAIN, 19 Medical<br />

Oncology Service, Catalan Institute of Oncology, Badalona (Barcelona), SPAIN,<br />

20 Clinic of Oncology, University Hospital Zurich, Zurich, SWITZERLAND<br />

Background: The Lungscape project aims at building a virtual biobank to facilitate<br />

an international high-quality analysis of large numbers of tumors for molecular<br />

alterations linked to clinical and biological characteristics captured in <strong>the</strong> iBiobank.<br />

Methods: Retrospective radically resected stage I-III non-small cell lung cancer cases<br />

from 15 ETOP centers, with mandatory comprehensive clinical annotations<br />

including at least 2 years of FU have been reviewed and captured.<br />

Results: This first set of 1614 cases was enriched in adenocarcinoma (61.8%), with<br />

28.8% of squamous and 4.9% of large cell histologies. Median age is 65 yrs, 37.6%<br />

are women, and respectively 13.9%, 33.5% and 49.6% are never, current and former<br />

smokers. Stage distribution is: IA 23.7%, IB 25.8%, IIA 16.4%, IIB 11.6%, IIIA 20.8%,<br />

IIIB 1.7%. At last FU, 52.8% of patients were still alive, with a median FU of 5.3 yrs.<br />

PFS<br />

No. of<br />

patients 5 years (95% C.I.)<br />

Median (mos)<br />

(95% C.I.)<br />

TOTAL 1614 46 (43.3, 48.6) 49.0 ( 43.9, 55.2)<br />

Stage Ia 382 64.5 (59.1, 60.5) NR<br />

Ib 417 55.4 (50.3, 60.5) 78.0<br />

IIa 264 44.8 (38.4, 51.3) 46.9<br />

IIb 187 39.2 (31.6, 46.8) 33.7<br />

IIIa 335 20.0 (15.2, 24.8) 17.5<br />

IIIb 28 11.9 (0.0, 25.3) 10.1<br />

OS 1614 52.0 (49.3, 54.7) 64.2 (57.3, 76.9)<br />

Stage Ia 382 70.0 (64.9, 75.2) NR<br />

Ib 417 60.6 (55.5, 65.7) NR<br />

IIa 264 50.5 (43.8, 57.1) 62.2<br />

IIb 187 43.7 (36.0, 51.4) 43.3<br />

IIIa 335 29.3 (23.9, 34.7) 29.0<br />

IIIb 28 10.3 (0.0, 27.1) 20.2<br />

Conclusion: This is <strong>the</strong> first large-scale series based on 7th TNM classification<br />

reporting on OS and PFS in <strong>the</strong> context of European standards of care. These data<br />

confirm <strong>the</strong> discriminative capacity of <strong>the</strong> 7 th TNM with a potentially somewhat<br />

superior outcome. Histologies o<strong>the</strong>r than adenocarcinoma are currently actively<br />

being captured. Complete data including PFS and TTP - never reported before - as<br />

well as OS based on <strong>the</strong> expected 2400 patients correlated to stage, gender, smoking<br />

status, histology and age will be provided. This complete clinical dataset will be<br />

Annals of Oncology 23 (Supplement 9): ix385–ix388, <strong>2012</strong><br />

doi:10.1093/annonc/mds407<br />

invaluable to investigate <strong>the</strong> impact of molecular characteristics on outcome. It will<br />

allow building future hypo<strong>the</strong>sis for prospective evaluation of new treatment<br />

strategies and help in <strong>the</strong> development of a molecularly refined TNM.<br />

Disclosure: All authors have declared no conflicts of interest.<br />

1180PD EXPRESSION OF HYPOXIA-INDUCED FACTOR 1α AND<br />

GLUCOSE TRANSPORTER 1 CORRELATES WITH<br />

[18F]-FLUORO-2-DEOXY-GLUCOSE UPTAKE ON<br />

POSITRON EMISSION TOMOGRAPHY AND TUMOR<br />

AGGRESSIVENESS IN DIFFERENT HISTOLOGIC SUBTYPES<br />

OF LUNG ADENOCARCINOMAS<br />

Y. Miyata, T. Furukawa, Y. Tsutani, T. Mimae, K. Misumi, T. Yoshiya, Y. Ibuki,<br />

M. Okada<br />

Surgical Oncology, Hiroshima University, Hiroshima, JAPAN<br />

Background: High maximal standardized uptake values (SUVmax) on<br />

[18F]-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) are<br />

associated with inferior survival in lung adenocarcinoma. However, <strong>the</strong> exact<br />

mechanisms are unknown. Here, we investigated <strong>the</strong> biological mechanisms<br />

underlying FDG uptake in different subtypes of adenocarcimomas.<br />

Methods: This retrospective study included 287 patients with adenocarcinoma (166<br />

with Stage IA). The patients underwent systematic tumor resection at Hiroshima<br />

University Hospital from January 2007 to December 2011, at <strong>the</strong> latest, 4 weeks after<br />

FDG-PET. The SUVmax values for primary lesions were calculated based on FDG<br />

uptake. Tumors were subdivided according to each morphologic growth pattern. The<br />

expression of hypoxia-inducible factor 1α (HIF1α) and glucose transporter 1 (GLUT1)<br />

was evaluated in 70 patients with 147 histologic subtypes using immunostaining.<br />

Results: There were significant differences in SUVmax and disease-free survival<br />

(DFS) among different histologic subtypes. Mean SUVmax and 5-year DFS were 0.90<br />

and 100% in is situ (n = 41), 1.1 and 100% in minimally invasive (n = 5), 1.8 and<br />

94.3% in lepidic (n = 66), 3.9 and 75.2% in papillary (n = 136), 5.4 and 91.7% in<br />

acinar (n = 26), and 7.6 and 71.6% in solid (n = 13) predominant subtypes. HIF1α<br />

and GLUT1, and GLUT1 and SUVmax were significantly correlated (p < 0.001 for<br />

both) in adenocarcinoma. Moreover, <strong>the</strong> expressions of HIF1α and GLUT1<br />

correlated with various clinicopathological factors relating to malignancy, such as<br />

pathological stage (I vs. II + III; p = 0.014), lymph node metastasis (p = 0.037),<br />

pleural invasion (p = 0.0093), lymphatic invasion (p < 0.001), and venous invasion<br />

(p < 0.001). GLUT1 and SUVmax were jointly associated with DFS (p = 0.0098 and<br />

p < 0.001, respectively in adenocarcinoma). There were significant differences in<br />

HIF1α and GLUT1 expression among different histologic subtypes. Mean HIF1α and<br />

GLUT1score were 0 and 0.15 in is situ (n = 13), 0.03 and 0.11 in lepidic (n = 36),<br />

0.19 and 1.0 in papillary (n = 52), 0.47 and 1.2 in acinar (n = 34), 0.11 and 1.6 in<br />

micropapillary (n = 9), and 2.3 and 3.0 in solid (n = 3) subtypes.<br />

Conclusions: In different histologic subtypes of lung adenocarcinomas,<br />

HIF1α-induced GLUT1 expression might explain high FDG uptake on PET and<br />

correlate with poor prognosis.<br />

Disclosure: All authors have declared no conflicts of interest.<br />

1181PD RANDOMIZED PHASE II STUDY OF ADJUVANT<br />

CHEMOTHERAPY WITH S-1 VERSUS CDDP + S-1 IN<br />

RESECTED STAGE II-IIIA NON-SMALL-CELL LUNG<br />

CANCER (WJOG4107)<br />

H. Yoshioka1 , Y. Iwamoto2 , S. Ito3 , T. Yamanaka4 , H. Tada5 , M. Yoshimura6 ,<br />

I. Okamoto7 , I. Yoshino8 , K. Nakagawa7 , Y. Nakanishi9 1 2<br />

Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, JAPAN, Medical<br />

Oncology, Hiroshima City Hospital, Hiroshima, JAPAN, 3 Department of Thoracic<br />

Surgery, Aichi Cancer Center Hospital, Nagoya, JAPAN, 4 Clinical Research<br />

Center, National Cancer Research Center, East Hospital, Kashiwa, JAPAN,<br />

5<br />

General Thoracic Surgery, Osaka City General Hospital, Osaka, JAPAN,<br />

6 7<br />

Thoracic Surgery, Hyogo Cancer Center, Akashi, JAPAN, Medical Oncology,<br />

Kinki University School of Medicine, Osakasayama, JAPAN, 8 General Thoracic<br />

Surgery, Chiba University Graduate School of Medicine, Chiba, JAPAN,<br />

9<br />

Research Institute for Diseases of The Chest, Kyushu University Hospital,<br />

Fukuoka, JAPAN<br />

Background: Postoperative cisplatin doublet chemo<strong>the</strong>rapy benefits patients with<br />

completely resected stage II-IIIA non-small-cell lung cancer (NSCLC). S-1 is an oral<br />

fluorinated pyrimidine formulation that combines tegafur (FT), 5-chloro-2,<br />

4-dihydroxypyridine (CDHP), and potassium oxonate in a molar ratio of 1:0.4:1 and<br />

© European Society for Medical Oncology <strong>2012</strong>. Published by <strong>Oxford</strong> University Press on behalf of <strong>the</strong> European Society for Medical Oncology.<br />

All rights reserved. For permissions, please email: journals.permissions@oup.com<br />

abstracts

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