1278PD - Major pathological response after preoperative chemotherapy as a surrogate marker of survival in early-stage non-small cell lung cancer: cohort of...

Date 11 September 2017
Event ESMO 2017 Congress
Session Non-metastatic NSCLC and other thoracic malignancies
Topics Anti-Cancer Agents & Biologic Therapy
Cancer in Adolescents
Non-Small-Cell Lung Cancer, Early Stage
Lung and other Thoracic Tumours
Presenter Jordi Remon Masip
Citation Annals of Oncology (2017) 28 (suppl_5): v453-v456. 10.1093/annonc/mdx381
Authors J. Remon Masip1, A. Martinez-Marti1, E. Carcereny Costa2, J. Zeron-Medina Cuairan1, I. Sansano3, J.L. Mate4, N. Pardo5, S. Cedres1, A. Navarro6, A.M. Martinez de castro5, T. Moran7, E. Felip Font8
  • 1Medical Oncology, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 2Medical Oncology, Catalan Institute of Oncology (ICO Badalona), Hospital Germans Trias i Pujol, 8916 - Badalona/ES
  • 3Pathology, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 4Pathology, Hospital Universitari Germans Trias i Pujol, 08916 - Badalona/ES
  • 5Medical Oncology, Vall d´Hebron University Hospital/Vall d´Hebron Institute Oncology, 08035 - Barcelona/ES
  • 6Deparment Of Oncology, University Hospital Vall d’Hebron, 08035 - Barcelona/ES
  • 7Medical Oncology, Hospital Universitari Germans Trias i Pujol, badalona/ES
  • 8Medical Oncology Service (lung Cancer Unit)  , Vall d'Hebron University Hospital, 08035 - Barcelona/ES

Abstract

Background

Randomized phase III NATCH trial in early-stage non-small cell lung cancer (NSCLC) patients (p) reported no statistically differences in disease-free survival (DFS) or overall survival (OS) with the addition of preoperative or adjuvant chemotherapy to surgery. In pre-operative arm, those p who achieved a complete response obtained a benefit in 5-year DFS rate (59% vs. 38%). Recently, major pathological response (MPR) to preoperative chemotherapy (10% or less of residual viable tumor after preoperative therapy) has reported as surrogate marker of OS. The aim of this study is to validate MPR as prognostic factor in a cohort of patients included the NATCH trial.

Methods

MPR was analysed in a whole cohort of 57 early-stage NSCLC p treated in the preoperative arm into NATCH trial from 2 institutions. OS according to MPR was analysed (long-rank test) in the whole population and by histologic subtype.

Results

In this cohort, median age was 67 years (47-78), 48 p (84%) were males, 26 p (46%) squamous subtype. By stage according to 6th TNM: 9 p (16%) stage IA, 35 p (61%) stage IB, 12 p (21%) stage IIB and 1 p (2%) stage IIIA. 95% p completed 3 cycles of preoperative treatment. Surgical procedures: 81% lobectomies, 14% pneumonectomies, 5% no surgery. 13 out of 57 p (22.8%) had MPR. In the whole population, there was an increase in 5-year OS among those patients with MPR compare to p without MPR (84.6% vs. 58.5%, p = 0.106). According to histological subtype, 5-year OS in squamous NSCLC p with MPR was significantly longer than in p without MPR (100% vs. 47.1%, p = 0.026), but not differences in OS in non-squamous were detected (66.7% vs. 66.7%, p = 0.586).

Conclusions

MPR is a prognostic value in squamous NSCLC p who receive preoperative chemotherapy. Validation in extended cohort merits further evaluation.

Clinical trial identification

Legal entity responsible for the study

Enriqueta Felip

Funding

None

Disclosure

All authors have declared no conflicts of interest.