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Poster Display session

291P - Preliminary results of cytisine therapy and tobacco cessation program in the Italian lung cancer screening program

Date

28 Mar 2025

Session

Poster Display session

Presenters

Massimiliano Cani

Citation

Journal of Thoracic Oncology (2025) 20 (3): S163-S180. 10.1016/S1556-0864(25)00632-X

Authors

M. Cani1, U. Pastorino2, E. Mercadante3, C. Battiloro4, A. Smedile5, V. Barbieri6, G.L. Pariscenti7, P. Gallina8, D. Bafunno9, A. Moretta10, A. Defilippis11, A. Cammarota12, G. Milanese13, P. Pattacini14, D. Patanè15, O. Caffo16, K. Ferrari17, S. Novello18

Author affiliations

  • 1 Università Degli Studi Di Torino - Orbassano, Orbassano/IT
  • 2 Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan/IT
  • 3 Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale, Napoli/IT
  • 4 Azienda Ospedaliera Dei Colli-Monaldi, Napoli/IT
  • 5 Department of Radiology, Papa Giovanni XXIII Hospital, Bergamo/IT
  • 6 A.O. Policlinico Mater Domini Università Degli Studi, Catanzaro/IT
  • 7 IRCCS San Martino Polyclinic Hospital, Genoa/IT
  • 8 Veneto Institute of Oncology IOV, Padoa/IT
  • 9 IRCCS Istituto Tumori Giovanni Paolo II, Bari/IT
  • 10 IRCCS Regina Elena National Cancer Institute, Roma/IT
  • 11 Thoracic Surgery Unit, Spirito Santo Hospital, Pescara/IT
  • 12 Diagnostic and Imaging Department, IRCCS CROB Centro di Riferimento Oncologico Della Basilicata, Rionero in Vulture/IT
  • 13 University of Parma, Parma/IT
  • 14 Radiology Department, AUSL - IRCCS di Reggio Emilia, Reggio Emilia/IT
  • 15 Department of Diagnostic and Interventional Radiology, Azienda Ospedaliera Cannizzaro, Catania/IT
  • 16 Ospedale Santa Chiara - APSS, Trento/IT
  • 17 Respiratory Medicine Unit, Careggi University Hospital, Florence/IT
  • 18 University of Turin, Orbassano/IT

Resources

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Abstract 291P

Background

In October 2022, the national study for Lung Cancer Screening (Rete Italiana Screening Polmonare RISP) was initiated across 18 Italian centers (NCT05766046). Volunteers aged 55–75 years, active or former heavy smokers were enrolled. Active smokers were offered a cessation program combining personalized counseling (individual or group behavioral therapy) with or without cytisine, a natural alkaloid acting as a partial agonist at nicotine acetylcholine receptors whose safety and efficacy has been proven. Here, we report preliminary results of the RISP cessation program with cytisine.

Methods

Data were extracted anonymously from the centralized eCRF. Baseline variables were assessed, and comparisons were made between volunteers treated with and without cytisine. Primary outcomes included smoking abstinence at 3, 6, and 12 months with cytisine. Secondary outcomes were dropout rates, relapse, cigarette reduction, and cessation in volunteers receiving only counseling and those diagnosed with lung cancer.

Results

As of October 2022, 9,828 volunteers were enrolled; 76.4% were active smokers. Only 12.5% joined the cytisine-based program (group A), and 27.8% received counseling alone (group B). Volunteers from North-West and Central Italy showed higher adherence to both screening and cytisine-supported cessation programs (p < 0.0001). Previous quit attempts and high nicotine dependence (Fagerström test) were associated with greater participation rates in group A (p < 0.0001). No significant differences were observed by sex, age, education, pack-years, or comorbidities. Smoking cessation rates in group A at 3, 6, and 12 months were 51.0%, 49.9%, and 49.4%, respectively, compared to 7.0%, 7.0%, and 5.9% in group B, even if direct comparisons are limited. In the group A 19.4% definitively dropped out, while 23.0% reported a median 63.0% cigarette reduction. Among 113 cancer diagnoses, 73.5% were active smokers; 51.8% quit post-diagnosis, with 34.9% supported by cytisine.

Conclusions

These findings confirm the efficacy of cytisine therapy in smoking cessation and emphasize the need to improve engagement in quitting programs and optimize volunteer management in lung cancer screening.

Clinical trial identification

NCT05766046.

Legal entity responsible for the study

Fondazione IRCCS Istituto Nazionale dei Tumori.

Funding

Italian Ministry of Health.

Disclosure

S. Novello: Financial Interests, Personal, Invited Speaker: AstraZeneca, MSD, Eli Lilly, Novartis, BeiGene, Amgen, Thermo Fisher; Financial Interests, Personal, Advisory Board: BI, BMS, Pfizer, Takeda, Roche, Sanofi, Amgen, J&J; Financial Interests, Institutional, Invited Speaker, IIT: MSD, BI; Financial Interests, Institutional, Invited Speaker: AstraZeneca, AMG, Eli Lilly, Sanofi, J&J, Roche; Non-Financial Interests, Personal, Leadership Role, president of this european advocacy: WALCE; Non-Financial Interests, Personal, Member: IASLC, AIOM, ASCO. All other authors have declared no conflicts of interest.

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