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Annals of Oncology
Results: The mean serum 25(OH)D concentration of 197 cases with lung cancer in
China was 10.63 ± 7.04ng/mL; the proportion of vitamin D deficiency was 173/197 in
all patients, 103/112 in adenocarcinoma. and 31/39 in squamous cell carcinoma. The
vitamin D deficiency ratio was higher in adenocarcinoma than in squamous cell
carcinoma, p= 0.043. PGJ2\DFOM can induce OCT4 + BASC to be CCSP-\SP-C +
\OCT4- cell, and then 1,25(OH)2D3 can prevent the expression re-recovery of
OCT-4 and CCSP. DAPT significantly lowered CCSP expression in OCT4 + BASC,
and then 1,25(OH)2D3 can make it become OCT4-\SP-C-\CCSP-\SP-B+ cell, which
is a mature AT2-like cell. 1,25(OH)2D3 has no effect on OCT4 + BASC or AT1-like
cell differentiation.
Conclusion: Lung cancer patients are generally lacking vitamin D, and lung
adenocarcinoma patients are more likely to be lacking vitamin D. 1,25(OH)2D3 can
promote lung adenocarcinoma progenitor cell differentiation.
Disclosure: All authors have declared no conflicts of interest.
1396P KBP-2010-CPHG: CHARACTERISTICS OF 6,083 NEW CASES
OF NSCLC ACCORDING TO SEX
D. Debieuvre 1 , C. Locher 2 , I. Bourlaud 3 , M. Zaegel 4 , M. Le Poulain-Doubliez 5 ,
J. Piquet 6 , T. Collon 6 , F. Martin 7 , F. Blanchon 2 , M. Grivaux 2
1 Pneumology, General Hospital, Mulhouse, FRANCE, 2 Pneumology, General
Hospital, Meaux, FRANCE, 3 Pneumology, General Hospital, Niort, FRANCE,
4 Pneumology, General Hospital, Le-Coudray-Chartres, FRANCE, 5 Pneumology,
General Hospital Manchester, Charleville-Mézières, FRANCE, 6 Pneumology,
General Hospital, Montfermeil-Le-Raincy, FRANCE, 7 Pneumology, General
Hospital, Compiègne, FRANCE
Lung cancer is a major public health problem due to its continued increase. In
2010, the French College of General Hospital Respiratory Physicians (CPHG)
performed a prospective multicenter epidemiological study (KBP-2010-CPHG) to
describe the baseline characteristics and management of all new cases of primary
lung cancer; to evaluate 1, 4 and 5-year patient survival rates; and to compare
results with those from a similar study performed 10 years ago (KBP-2000-CPHG).
Data were collected on a standardized form for all patients ≥18 years with primary
lung cancer, histologically or cytologically diagnosed between January 1 and
December 31, 2010 and managed in a general hospital. 7,610 patients were enrolled
in 119 centers. 6,083 patients (86.3%) had non-small-cell lung cancer (NSCLC);
among them, 24.4% were female (vs. 16% in 2000; p < .0001). There was no
difference between male and female NSCLC patients regarding age (65.7± 10.9 vs.
64.9± 13.0, p = 0.03). Regarding smoking status, between 2000 and 2010, women
remained more frequently non-smoker compared to men (34.2% vs. 4.7%), less
frequently former smoker (21.3% vs. 46.8%) and showed lower consumption (37.2
vs. 43.7 PY) (p < .0001). However, in 2010, the percentage of non-smokers nearly
doubled in men (2.5% vs. 4.7%; p < .0001) whereas it remained stable in female (p
< .32). Regarding tumor characteristics, between 2000 and 2010, the percentage of
adenocarcinomas significantly increased in both women (53.4% in 2000 vs. 65.9% in
2010; p < .0001) and men (32.4% vs. 49.4%; p < .0001). However, in 2010, tumors
remained more frequently adenocarcinomas in women than in men (65.9%
vs.49.4%; p < .0001). In addition, in 2010, when explored (48.5% in women vs.
31.0% in men; p < .001), an EGFR mutation was more frequently found in women
than men (20.6% vs. 5.2%; p < .0001), stage IV tumor was more frequent in women
than men (62.4% vs. 56.9%; p = 0.0008), and regarding first-line treatment, 64.5% of
women vs. 61.0% of men (p = .01) received chemotherapy and 13.4% of women vs.
5.7% of men (p < .0001) targeted therapy. In 10 years, percentages of women,
non-smokers among men, and adenocarcinomas in both men and women
increased. However, differences between women and men in baseline and tumor
characteristics persist.
Disclosure: All authors have declared no conflicts of interest.
1397P CARDIAC SAFETY OF (NEO) ADJUVANT TRASTUZUMAB IN
THE BRAZILIAN COMMUNITY SETTING: A SINGLE CENTER
EXPERIENCE
L.G. Fonseca 1 , T.K. Takahashi 2 , M.P. Mak 2 , R. Barroso-Sousa 1 , L. Testa 2 ,V.
Petry Helena 1 , R. De Paula Costa 1 , P.M. Hoff 1 , M.S. Mano 1
1 Medical Oncology, ICESP, Sao Paulo, BRAZIL, 2 Medical Oncology, Instituto do
Cancer do Estado de Sao Paulo ICESP, Sao Paulo, BRAZIL
Background: Trastuzumab-associated cardiotoxicity (TAC) has been established in
the context of clinical trials. However, when newly registered agents are used in a
broader patient population, their safety profile does not always mirror that of the
pivotal trials. Trastuzumab (T) only became available in the Brazilian public sector in
2008 and herein we report our off-trial experience so far.
Methods: Retrospective, single center cohort of HER-2 positive breast cancer patients
(pts) treated with (neo)adjuvant chemotherapy and T from July 2008 to March 2012.
95.3% were treated according to local protocol (11.4% TCH; 83.9% AC-TH). Major
cardiac event (MCE) was defined as a left ventricular ejection fraction (LVEF) drop
of 10% and absolute drop to < 50 % by echocardiogram (ECHO) or as symptomatic
heart failure (HF) regardless of the LVEF value or any cardiac event considered
clinically meaningful. A multivariable Cox proportional hazards model was used to
control for other cardiac risk factors.
Results: 237 women were identified: median age 53 y (27-83), 99.6% ECOG-PS 0-1,
median body mass index 27.4 kg/m 2 (17 – 46), 30.4% had hypertension (HTN), 8.8%
had diabetes mellitus (DM), 5.9% had previous cardiopathy. 54.8% had ER-positive
tumors; 40.7% received neoadjuvant T; most were stage II or III (22.3% and 37.1%).
Median number of ECHO assessments was 2.7 (0-6); 136 pts (57.2%) completed T as
planned. 20.2% had MCE (13.9% discontinued T). 3.8% discontinued T due to
symptomatic HF and 5% for non-cardiac reasons. 41.6% of MCE pts recovered
cardiac function. Median initial LVEF was 64.83 ± 1.5 % (no event) vs 64.81 ± 1.5 %
(MCE) p = 0.26; median 3-month LFVE was 64.67 ± 4 % (no event) vs 56.12 ± 3 %
(MCE) p = 0.0036. HTN, DM, obesity, age, radiotherapy, use of anthracycline and
previous cardiopathy were not significantly associated with TAC.
Conclusions: Our results suggest that TAC in our routine practice is slightly higher
than reported in literature (6 to 17%), possibly reflecting selection bias in clinical
trials. Symptomatic TAC was as expected for AC-TH (4%). We failed to identify risk
factors for TAC, possibly due to the low number of events. Cardiac function must be
closely monitored during T treatment and careful pt selection is crucial.
Disclosure: All authors have declared no conflicts of interest.
1398P CLINICO-PATHOLOGICAL CHARACTERISTICS AND
TREATMENT OUTCOME OF YOUNG BREAST CANCER
PATIENTS: AN INSTITUTIONAL STUDY
V. Raina 1 , A. Gogia 2 , S.V.S. Deo 3 , B.K. Mohanti 4 , N.K. Shukla 3
1 Dept. of Medical Oncology, All India Institute of Medical Sciences (AIIMS)
Institute Rotary Cancer Hospital, New Delhi, INDIA, 2 Medical Oncology, All India
Institute of Medical Sciences (AIIMS) Institute Rotary Cancer Hospital, New Delhi,
INDIA, 3 Surgical Oncology, AIIMS, New Delhi, INDIA, 4 Radiation Oncology, All
India Institute of Medical Sciences (AIIMS) Institute Rotary Cancer Hospital, New
Delhi, INDIA
Background: Breast cancer in young women (right side). Ninety percent of patients were married and median age at first child
birth was 23 years. Positive family history was elicited in 10 patients. Five patients
presented with synchronous malignancy. The TNM (7th edition) stage distribution was
stage I - 2.5 %, stage II - 30%, stage III - 46.5%, and stage IV - 22%. The median clinical
tumor size was 5.0 cm. Modified radical mastectomy was the commonest surgical
procedure and this was done in 83 % of cases. The histopathological analysis showed
94% had infiltrating ductal carcinoma. Thirty percent of tumors were high grade and
70% had pathological node-positive disease. ER/PR and Her2neu positivity was 33% and
29%, respectively. Triple-negative breast cancer (TNBC) constituted 31%. A combination
of anthracyclines and taxanes were used in the majority of patients and trastuzumab was
used only in 3 % of cases. With a median follow up of 28 months (non-metastatic
group), 3-year disease-free survival (DFS) and overall survival (OS) was 50% and 60%.
Higher Nodal stage, tumor size (>5 cm), negative hormonal status (triple negative) and
visceral metastasis at baseline predicted poor outcome.
Conclusion: Young women constituted 7.5 % of breast cancer cases. The proportion
of triple negative (nearly one third) was also higher than the Western population.
Higher stage and triple negative status results in poorer outcome.
Disclosure: All authors have declared no conflicts of interest.
1399P MALNUTRITION AS A DETERMINANT OF OUTCOME OF
PEDIATRIC CANCER PATIENTS
S. Banerjee 1 , S. Mukhopadhyay 1 , S. Gangopadhyay 1 , A. Mukhopadhyay 2
1 Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute,
Kolkata, INDIA, 2 Medical Oncology, Netaji Subhas Chandra Bose Cancer
Research Institute, Kolkata, INDIA
Childhood cancer is curable. Malnutrition poses a major problem amongst Indian
children with around 40% of them suffering from undernourishment and starvation.
It is one of the causes of poor outcome and toxicity of cancer patients. This study
will help to highlight the close knitted relationship between the nutritional status and
its influence on complete remission, disease free survival (DFS) and
chemotherapeutic toxicity. In the present study, 500 cancer affected children were
analyzed, who were being treated during a period from Jan, 2007 to Dec, 2011. The
age range was 1-18 years (mean 12.5 years). There was male preponderance.
Distribution of cases: Acute lymphoblastic leukemia 42%, Acute myeloid leukemia
8%, Non Hodgkin’s and Hodgkin’s leukemia 14%, Rhabdomyosarcoma and other
Volume 23 | Supplement 9 | September 2012 doi:10.1093/annonc/mds410 | ix455