Annual Meeting Proceedings Part 1 - American Society of Clinical ...

1530 Poster Discussion Session (Board #19), Sun, 8:00 AM-12:00 PM and
11:30 AM-12:30 PM
Potential risk of asbestos exposure among Japanese general population:
Japanese general screening study for asbestos-related diseases (JGSARD).
Presenting Author: Nobuhiko Seki, Teikyo University School of Medicine,
Tokyo, Japan
Background: The number of patients with pleural mesothelioma and lung
cancer associated with asbestos exposure has recently been increasing in
Japan. The aim of this study was to evaluate the results of screening for
asbestos-related diseases in a group of Japanese general population.
Methods: This prospective study was approved by the institutional review
board. From 2006 to 2008, 9810 subjects (5283 men and 4527 women;
mean age, 57 years) underwent chest radiography and low-dose CT
examinations in 26 institutions in Japan. Among them, 6286 (64.1%)
subjects underwent subsequent CT examinations after 2 years of interval.
Clinical information such as histories of smoking and asbestos exposure
was reviewed. Images were interpreted independently by 15 experienced
pulmonologists or chest radiologists. Results: The history of asbestos
exposure was definitely present in 1253 (12.8%) subjects, possibly
present in 2058 (21.0%), and absent in 6499 (66.2%). On chest
radiograph, pleural plaque and thickening were seen in 61 (0.6%) and 65
(0.6%) subjects, respectively. On low-dose CT, pleural plaque and thickening
were identified in 264 (2.7%) and 245 (2.5%) subjects, respectively,
and non-calcified pulmonary nodule/mass was seen in 1003 (10.2%).
Furthermore, lung cancer was identified in 29 (0.3%) subjects. The history
of asbestos exposure was not confirmed in 77 out of 264 subjects (29.2%)
having pleural plaques on low-dose CT. Based on the logistic regression
analysis, pleural plaque on low-dose CT was significantly correlated with
male, age more than 60 years, smoking, and a history of asbestos exposure.
Especially, total residential period in asbestos factory area as well as
asbestos exposure work period showed significantly increased relative risk
every 10 years. Similarly, lung cancer was significantly correlated with age
more than 60 years, a history of asbestos exposure, and presence of pleural
plaques. Conclusions: Our results indicate the presence of pleural plaques
on low-dose CT among Japanese general population is closely associated
with potential risk of asbestos exposure. However, about 30% of such
subjects are not aware of a history of asbestos exposure.
1533 Poster Discussion Session (Board #22), Sun, 8:00 AM-12:00 PM and
11:30 AM-12:30 PM
Clinical characteristics and natural history of patients with squamous cell
lung carcinoma with FGFR1 amplification. Presenting Author: Marc Bos,
Lung Cancer Group Cologne, Department I of Internal Medicine and Center
for Integrated Oncology, University Hospital Cologne, Cologne, Germany
Background: FGFR1 amplifications have been described as a promising
oncogenic target in squamous cell lung cancer. Here we aimed at
describing the clinical characteristics and natural history of FGFR1amplified
squamous cell lung cancer patients. Methods: From 01/2011 to 01/2012
we screened 553 squamous cell lung cancer patients in our Network for
Molecular Screening of Lung Cancer for the presence of FGFR1 amplifications
by FISH analysis in accordance with the local ethics committee.
FGFR1 was defined as amplified if the ratio of FGFR1 copies to centromeric
copies was above 2 or if more than 50% of tumor cells showed 5 copies or if
more than 15% of tumor cells demonstrated clusters of FGFR1. Clinical
data were collected by extracting information from medical records, the
local cancer registry and by questioning treating physicians and patients.
Results: FGFR1FISH analysis could be performed in 95% of the cases and
was amplified in 16%. Of the amplified cases 75 % were male and 25%
female without significant enrichment for male or female. The median age
of the patients at diagnosis was 67 yrs (range 46 - 82). Stage at
presentation was: 16% I; 17.3% II; 26.7% IIIa, 40% IIIb/IV. 97,3% of the
patients were former or active smokers with a median of 40 pack years. The
median progression free survival of patients with stage IIIb/IV disease was
11 months (95% CI 8-14; n�14). The median overall survival was not yet
reached after a median follow-up time of 14 months (95% CI 11 - 17;
n�24). We further screened for co-existing genetic lesions such as
mutations in EGFR, BRAF, KRAS, PIK3CA as well as translocations of ALK
and amplifications of ERBB2. Two patients demonstrated co-occurring
PIK3CA mutations and one a BRAFmutation. Conclusions: Screening for
FGFR1 is feasible under routine clinical conditions. By implementation of a
regional molecular screening network the ability to screen for FGFR1
amplification was successfully expanded to non-academic centers and
private practices. FGFR1 amplifications in squamous cell cancer of the
lung are frequent (16%) and associated with smoking history. Screening for
FGFR1 might pave the way for the application of new FGFR1 directed
targeted drugs in squamous cell lung cancer.
Cancer Prevention/Epidemiology
93s
1531 Poster Discussion Session (Board #20), Sun, 8:00 AM-12:00 PM and
11:30 AM-12:30 PM
Never-smoking women with lung cancer from the Spanish WORLD07
database. Presenting Author: Dolores Isla, Hospital Lozano Blesa, Zaragoza,
Spain
Background: Gender differences in lung cancer (LC) have been reported,
but with many unresolved issues yet. Tobacco causes the majority of
women lung cancer (WLC), although the rate of never-smoking WLC is
higher than in men. Several factors may play etiologic roles, and an
in-depth understanding is needed. Methods: WORLD07 is a Spanish
prospective, multicenter, epidemiologic female-specific LC database sponsored
by ICAPEM, a professional association committed with WLC research.
In order to improve the knowledge on never-smoking WLC,
information has been extracted from WORLD07 database. Results: From
October/2007 to October/2011, 1371 newly diagnosed WLC were included
in an e-database from 32 centers, 539 (39.3%) never-smoking.
Patient (p) characteristics: median age 71.1 years(y); median age of
menarche 13y.; motherhood 91.2% (median 2.3 children, median age at
first child 26.4y); oral contraceptive use 11.9%; postmenopausal 88.9%
(median age of menopause 49y); HRT 5.2%; second-hand smokers 40%
(work-exposure 17.1%, home-exposure 88.8%); obesity 16.3%; familiar
history of cancer 39.9% (LC 29.8%); previous history of cancer 13%
(breast/lung/cervix: 41.4/5.7/2.9%); current LC histology(%): adenocarcinoma/SqCC/LCC/SCLC:
83.4/6.2/5.5/3.9; EGFR mut� (268 p analyzed):
55.5% (exon 19/20/21(%): 61.1/7.4/36.9); TNM NSCLC I/II/III/IV(%):
14/3.3/19.8/60.3. Treatment: EGFR-TKI in p EGFR mut�, stage IV(1st-/ 2nd-line)(%): 51.7/15.4; stage IV NSCLC (1st-line/2nd-line): platinumbased
CT 42.5%, EGFR-TKI 33.5%, combinations with bevacizumab
2.9% / EGFR-TKI 15.8%. Overall survival: median 27 months(m), 1/2y(%)
74.8/55.2; stage IV NSCLC: median 20.5m, 1/2-y(%) 67/46;
EGFR-mut� p: median 27.3m, 1/2-y(%) 75/54.3. Conclusions: According
to our e-database, WLC showed high rates of never-smokers (39.3%), and
of relatives diagnosed with malignant tumours (39.9%, �1/3 LC). Adenocarcinoma
was the most frequent histology (76.1%), and more than half of
the cases analyzed harboured EGFR mutations. Although 40% were
second-hand smokers, further investigations are warranted. Survival outcomes
remain satisfactory, as expected from this selected subgroup of p.
Additional epidemiologic and treatment data will be presented.
1534 Poster Discussion Session (Board #23), Sun, 8:00 AM-12:00 PM and
11:30 AM-12:30 PM
Molecular epidemiological prospective study of EGFR mutations from
Asian patients (pts) with advanced lung adenocarcinoma (PIONEER).
Presenting Author: Pan-Chyr Yang, National Taiwan University Hospital,
College of Medicine, Taipei, Taiwan
Background: The epidemiological, multicenter prospective study
(NCT01185314; PIONEER) assessed EGFR mutation (M) rates in pts from
Asia with newly diagnosed advanced lung adenocarcinoma (ADC). Influence
of demographic and clinical factors on EGFR M rates was investigated.
Methods: Pts were aged �20 years, with treatment naïve stage
IIIB/IV lung ADC. Tumor sample (biopsy, surgical specimen, cytology)
EGFR M status (primary endpoint; positive [M�], negative [M-], undetermined
[MU]) was determined using Scorpion ARMS (Therascreen EGFR
RGQ kit). EGFR M frequency was calculated and compared between
demographic/clinical factor subgroups (chi-square/Fisher’s exact test).
Factors with p�0.05 in the univariate analysis were further analyzed by
multivariate logistic regression at 1% significance level to take the large
dataset into consideration. Results: Of 1482 pts from 7 Asian countries,
43.4% were female, mean age was 60 years (range 17-94), and 52.6%
were never-smokers. EGFR M status was evaluated in 1450 patients (32
[2.2%] were MU): 746 (51.4%) were M�, 704 (48.6%) were M-. Country,
gender, ethnicity, smoking status, pack years, metastasis, (all p�0.001)
and disease stage (p�0.009) correlated significantly with EGFR M status.
EGFR M� rate by country: Vietnam 64.2% (77/120), Taiwan 62.1%
(108/174), Thailand 53.8% (63/117), Philippines 52.3% (34/65), China
50.2% (372/741), Hong Kong 47.2% (76/161), India 22.2% (16/72).
EGFR M� rates were 61.1% in females, 44.0% in males, 60.7% in never
smokers, and 31.4% in heavy smokers (�50 pack years). EGFR M� rates
were 37.5% in male regular smokers (113/301), 34.8% in female regular
smokers (8/23), 56.5% in male never smokers (104/184) and 62.0% in
female never smokers (358/577). Ethnic group (p�0.001) and pack years
(p�0.001) were identified as important factors by logistic regression;
gender was not significant when adjusted for smoking status. Conclusions:
The overall EGFR M� rate in unselected ADC was 51.4%. Ethnicity and
pack years were found to have a statistically significant association with
EGFR M rates. There was no association between gender and EGFR M rates
when adjusted for smoking status.
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