1465P - Updated data on clinical and molecular profile of surgically resected small cell lung cancer: Intergroup study with FIGHT002 and HOT1301

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Small-Cell Lung Cancer
Translational Research
Surgery and/or Radiotherapy of Cancer
Presenter Yuka Fujita
Citation Annals of Oncology (2014) 25 (suppl_4): iv511-iv516. 10.1093/annonc/mdu355
Authors Y. Fujita1, H. Yokouchi2, H. Nishihara3, T. Ishida4, H. Suzuki5, H. Uramoto6, S. Yamazaki7, H. Kikuchi8, K. Akie9, F. Sugaya10, K. Takamura11, M. Harada12, T. Harada13, M. Higuchi14, M. Maemondo15, O. Honjo16, H. Akita17, H. Isobe18, M. Nishimura19, M. Munakata2
  • 1Department Of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, 070-8644 - Asahikawa/JP
  • 2Pulmonary Medicine, Fukushima Medical University, 960-1295 - Fukushima/JP
  • 3Department Of Translational Pathology, Hokkaido University, 060-8638 - Sapporo/JP
  • 4Clinical Oncology Center, Fukushima Medical University, 960-1295 - Fukushima/JP
  • 5Thoracic Surgery, Fukushima Medical University, 960-1295 - Fukushima/JP
  • 6Second Department Of Surgery, University of Occupational and Environmental Health, Kitakyushu/JP
  • 7Thoracic Surgery, Keiyukai Sapporo Hospital, Sapporo/JP
  • 8First Department Of Medicine, Hokkaido University, Sapporo/JP
  • 9Department Of Pulmonary Disease, Sapporo City General Hospital, 0608604 - Sapporo/JP
  • 10Division Of Respiratory Medicine, Teine Keijinkai Hospital, Sapporo/JP
  • 11First Department Of Medicine, Obihiro-Kosei General Hospital, Obihiro/JP
  • 12Department Of Pulmonary Disease, National Hospital Organization Hokkaido Cancer Center, 0030804 - Sapporo/JP
  • 13Center For Respiratory Diseases, JCHO Hokkaido Hospital, 062-8618 - Sapporo/JP
  • 14Department Of Thoracic Surgery, Fukushima Red Cross Hospital, Fukushima/JP
  • 15Department Of Respiratory Medicine, Miyagi Cancer Center, Natori/JP
  • 16Department Of Respiratory Medicine, Sapporo-Kosei General Hospital, Sapporo/JP
  • 17Department Of Medical Oncology, Hokkaido University Graduate School of Medicine, 0608638 - Sapporo/JP
  • 18Department Of Medical Oncology, KKR Sapporo Medical Center, Sapporo/JP
  • 19First Department Of Medicine, Hokkaido University School of Medicine, 060-8638 - Sapporo/JP



NCCN and Japanese guidelines suggest surgery for patients with c-stage I small-cell lung cancer (SCLC), and ESMO guidelines recommend surgery for patients with c-stage II (T1,2 N0,1). However, the clinical impact of surgery with other variables on patients with early stage SCLC has yet to be determined. Therefore, clarification of the clinical and molecular profile of surgically resected SCLC is required. We expanded the number of patients and updated the clinical data which had been presented at ASCO 2014 (abstract #7590).


We reviewed the clinical courses of 156 patients with SCLC who had undergone surgery at 17 institutes from January 2003 to January 2013. 125 formalin-fixed paraffin-embedded tissue samples were subjected to immunohistochemistry using 8 antibodies and to next-generation sequencing (NGS) systems using MiSeq and TruSight Tumor Sequencing Panel (Illumina) loading 26 genes. (UMIN registration No. 000010116 /10117).


Median relapse-free survival (RFS) and overall survival (OS) were 15.6 (95%CI: 6.8-24.5), and 33.3 (20.9-45.8) months, respectively. Multivariate analysis revealed that OS was longer in patients without history of malignancy (HR: 0.459, 95%CI: 0.248-0.847, p=0.013), with preoperative diagnosis (HR: 0.529, 95%CI: 0.293-0.953, p=0.034), and with c-stage II and under (HR: 0.117, 95%CI: 0.047-0.288, p<0.001). Of the 125 patients whose samples were available, MED12 and TGF-ßRII were highly expressed in nucleus and cytoplasm, respectively in 92% and 55% of the samples. None of the tumors expressed ALK. There was no relationship between the expression of c-Met, EGFR, and VEGFRII and either of RFS or OS. Univariate analysis demonstrated that high expression of c-Kit in tumor is an independent factor for longer OS (HR=0.606, 95%CI: 0.379-0.971, p=0.037). 79 samples have been subjected to NGS so far. However, no druggable mutations of BRAF, EGFR, ERBB2, KRAS, KIT, PDGFRA, PIK3CA, FOXL2, GNAQ, GNAS, and FGFR2 were found.


These results support the ESMO guidelines for the management of c-stage II small-cell lung cancer, and indicate that history of malignancy might be a major decisive factor for surgery. The results of immunohistochemistry assist us in gaining a better understandingof the biology of SCLC.


All authors have declared no conflicts of interest.