Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster session 13

1192P - Smoking adversely affects survival of metastatic lung carcinoid patients: Analysis of a large international audit

Date

21 Oct 2023

Session

Poster session 13

Topics

Tumour Site

Neuroendocrine Neoplasms;  Thoracic Malignancies

Presenters

Sara Valpione

Citation

Annals of Oncology (2023) 34 (suppl_2): S701-S710. 10.1016/S0923-7534(23)01264-4

Authors

S. Valpione1, A. Clarke1, A. Cunningham1, A. Garcia Alvarez2, L. Spurgeon1, R.D. Morgan3, A. Carmona4, J. Hernando5, J. Capdevila Castillon6, A. Backen1, L. Campana7, P. Manoharan8, A. Verma9, G. Lord10, W. Mansoor1

Author affiliations

  • 1 Medical Oncology, The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
  • 2 Medical Oncology Dept., Vall d'Hebron University Hospital, 8035 - Barcelona/ES
  • 3 Medical Oncology Department, The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
  • 4 Medical Oncology Department, Vall d'Hebron Institute of Oncology, 08035 - Barcelona/ES
  • 5 Medical Oncology Department, Vall Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), 08035 - Barcelona/ES
  • 6 Gastrointestinal And Endocrine Tumor Dept., Vall d'Hebron University Hospital, 8035 - Barcelona/ES
  • 7 General Surgery, MRI - Manchester Royal Infirmary, M13 9WL - Manchester/GB
  • 8 Radiology, The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
  • 9 Public Health, Epidemiology, The University of Manchester, M13 9PL - Manchester/GB
  • 10 Faculty Of Biology, Medicine And Health, The University of Manchester, M13 9PL - Manchester/GB

Resources

Login to get immediate access to this content.

If you do not have an ESMO account, please create one for free.

Abstract 1192P

Background

Among neuroendocrine lung cancers, lung carcinoids (LC, further divided into typical [TC] and atypical [AC]) are rare, representing only the 2% of all bronchopulmonary malignancies, and lack prognostic classification and stratification.

Methods

We audited two international cohorts of patients with a confirmed diagnosis of LC for prognostic analysis. We used data from The Christie Hospital (Manchester, UK; N=282) and validated our findings using the cohort of Vall d’Hebron Hospital patients (Barcelona, Spain, N=80). We collected patient data and applied modelling strategies to identify a prognostic model for metastasis-free survival (MFS) and overall survival (OS) from metastatic disease.

Results

Blood lactic dehydrogenase (LDH) and tumour Ki67% were significant at multivariable analysis (stratified for stage) for MFS (C-index=0.69, P=0.0016), while histological subtype (TC vs AC) and other clinical variables were not. Independent prognostic factors for OS from onset of metastases included smoking history, along with known factors (patient age and performance status, proliferation index, PET maximum SUV). The model C-index was 0.84 (P=0.01678), with optimal concordance when applied to the external validation cohort from Vall d’Hebron. Previously undescribed, patients with smoking history lived shorter (median OS 34 months vs not reached, P<0.0001), and our data also suggested that the median OS could be shorter in current smokers (26.2 months) compared to ex-smokers (35.3 months).

Conclusions

We provide a novel prognostic tool to estimate patient risk, clinical trial stratification and assist clinical decisions in the rarest lung tumours. LDH blood levels have not been described as prognostic in this disease, so provide a new reliable biomarker to stratify MFS. We also describe for the first time that smoking history is an independent prognostic factor for overall survival in this cancer. Our results warrant to update the prognostic factors for LC and provide evidence to recommend that patients should stop smoking.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

S. Valpione: Other, Institutional, Research Grant: Amgen. G. Lord: Financial Interests, Personal and Institutional, Advisory Board: Gritstone Bio. W. Mansoor: Financial Interests, Institutional, Advisory Board: Ipsen, Novartis, Pfizer, MSD, BMS, Servier, Amgen; Financial Interests, Institutional, Research Grant: Nordic, MSD. All other authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.