Abstract 249P
Background
Solid organ transplantation (SOT) is a curative intervention for terminal diseases, although it is associated with complications, including the risk of cancer. This study examines the characteristics of patients developing lung cancer after SOT.
Methods
We analyzed all the patients transplanted from 2008 to 2023 in a third-level Hospital with maximum transplant capacities and national reference in these aspects. Specifically, those who developed lung cancer in the follow-up after transplantation.
Results
From 2008 to 2023, our center performed 1482 solid organ transplantations (heart, kidney, lung and liver). In our analysis, 262 patients developed cancer, of whom 34 were diagnosed with lung cancer (Table). The average age at diagnosis was 62.4 years, and 70% were diagnosed at an advanced stage. The median time from solid organ transplant (SOT) to cancer diagnosis was 52.2 months. Of the 11 patients diagnosed at an early stage (I-III), 6 (54.5%) underwent surgery, all of them were stage I (IA-IB 7th edition AJCC-TNM classification). No patient received neo/adjuvant treatment. Two (18.2%) patients received radical radiotherapy and two (18.2%) patients died due to a complication at the time of diagnosis. three patients (27.3%) diagnosed at an early stage experienced disease recurrence. In the advanced stage, 42% did not receive any oncologic treatment. 54% received systemic treatment, mostly (80%) a platinum doublet. None received immunotherapy or participated in clinical trials. The median overall survival for patients with stage IV was 4 months (95% CI 2-5.9 months). No significant differences were found in terms of survival in advanced disease based on transplanted organ (p=0.56), histology (p=0.10), gender (p=0.89), or smoking status (p=0.89). Table: 249P
| Table-1 (N=34) | ||
| Transplanted organ | Heart 5 (14.7%) Liver 7 (20.6%) Lung 16 (47.1%) Kidney 6 (17.6%) | |
| Gender | Male: 26 (76.5%) Female: 8 (23.5%) | |
| Smoking status | Smoker: 8 (23.53%) Former Smoker: 22 (64,7%) Never smoker: 4 (11,7%) | |
| Stage I-III IV | 11 (32.4%) 23 (67.6%) | |
| Histology Adenocarcinoma Saquamous NSCLC-NOS SCLC unknown | 14 (41.2%) 9 (26.5%) 2 (5.9%) 6 (17.6%) 3 (8.8%) | |
| Driver mutations (N=16 NSCLC, non-squamous) EGFR: ALK: ROS1: | Tested: | Positive: |
| 10 (62.5%) | 0 | |
| 9 (56.2%) | 0 | |
| 6 (37.5%) | 1 | |
| PDL1 (N=25 NSCLC): | Tested: 8 (32%). PDL1 ≥ 50%: 1 (12.5%) | |
| Treatment (stage IV) N=26 | Palliative care: 11 (42.3%) Systemic treatment: 14 (53.93%) Platinum doublet: 12 (85.7%) Monotherapy: 2 (14.3%) RT: 1 (3.8%) |
Conclusions
In SOT patients, lung cancer has a poor prognosis. There is a higher percentage of patients undergoing palliative treatment and there is a need to design specific treatments for these patients.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.