WCIM 2014 SEOUL KOREA 459
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 1604 Lung Cancer
BIM Deletion Polymorphism in Patients with Non-Small Cell Lung Cancer Treated with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors
Hong-Joon Shin1, Chul-Kyu Park1, Bo-Ram Lee1, Hee-Jung Ban1, Yong-Soo Kwon1, In- Jae Oh1, Kyu-Sik Kim1, Yu-Il Kim1, Sung-Chul Lim1, Young-Chul Kim1
Department of Internal Medicine, Chonnam National University Medical School, Korea1
Background: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are the most important agents for the treatment in patients with advanced non-small cell lung cancer (NSCLC) who have EGFR mutation. Recent several studies reported that B-cell chronic lymphocytic leukemia/lymphoma (Bcl-2)-like 11 (BIM) deletion pol- ymorphism is associated with primary resistance to EGFR TKIs therapy. So we studied outcomes of patients who are treated with EGFR TKIs for NSCLC according to pres- ence of BIM deletion.
Methods: We retrospectively studied 102 patients who underwent surgery for NSCLC at Chonnam National University Hwasun Hospital between January 2003 and March 2014. All of 102 samples were formalin-fixed paraffin-embedded slides of surgical specimens, and we analyzed BIM deletion by polymerase chain reaction and EGFR mutation by PNA clamping. The overall response rate(ORR), disease control rate(DCR), overall survival(OS) and progression free-survival (PFS) were compared between pa- tients with and without BIM deletion.
Results: BIM deletion was detected in 23 of 102 (22.5%). A total of 41 (10 with BIM deletion vs. 31 without BIM deletion) of 102 had EGFR mutation. There were no sig- nifi cant differences between patients with and without BIM deletion (ORR, 21.7% vs 20.3%; p=0.542; DCR, 56.5% vs 67.1%; p=0.458). The median OS in patients with BIM deletion was 11.3 months, and that in patients without BIM deletion was 11.4 months (hazard ratio [HR],0.76; 95% confi dence interval [CI], 0.29-1.99; p=0.585). The median PFS for the BIM deletion positive group was 1.5 months, compared with 3.3 months for the BIM deletion negative group (HR, 2.30; CI, 0.75-7.03; p=0.141).
Conclusions: This retrospective study showed that the BIM deletion polymorphism does not infl uence outcomes in patients with NSCLC who are treated with EGFR-TKIs.
PS 1605 Lung Cancer
Diabetes Mellitus Predicts Poor Responses to Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase inhibitor (TKI) in Non-Small Cell Lung Cancer Patients Harboring Activating EGFR Mutations
Chang Dong Yeo1, Sang Haak Lee1, Seung Joon Kim1, Hyoung Kyu Yoon1, Tae Jung Kim2
Department of Internal Medicine, The Catholic University of Korea, Korea1, Department of Pathology, The Catholic University of Korea, Korea2
Background: The presence of diabetes mellitus (DM) has been known as a poor prognostic factor in lung cancer and is associated with insulin-like growth factor 1 receptor (IGF-1R) over-expression. The IGF-1R pathway has a role in the acquisition of resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs).
The aim of the present study is to determine the predictive role of DM to EGFR TKIs in NSCLC patients harboring sensitizing EGFR mutations.
Methods: We retrospectively analyzed 68 recurrent or metastatic NSCLC patients who had activating EGFR mutations and received TKIs (gefi tinib, erlotinib, afatinib).
Comparison of progression free survival (PFS) according to the presence of DM was performed from all patients received EGFR-TKIs.
Results: Of 68 EGFR-mutated patients, 14 (20.6%) had DM, 18 (26.5%) were male, and 65 (95.6%) had non-squamous histology. Among them, 52 (76.5%) received TKIs as the fi rst-line treatment, and 54 (79.4%) patients were given gefi tinib. There were no differences of clinicopathologic characteristics according to the presence of.
Patients with DM showed signifi cant shorter PFS (8.8 vs. 15.3 months, p=0.048) than those without DM from the patients received 1st line TKIs. Higher IGF-1R expression in tumor tissues by immunohistochemistry was observed from patients with DM.
Conclusion: DM showed a negative predictive factor to the 1st-line EGFR TKIs in NS- CLC patients harboring activating EGFR mutations. Further studies to overcome EGFR resistance in diabetic patients are clinically warranted regarding the IGF-1R pathways.
PS 1606 Lung Cancer
Dyspnea as an Independent Prognostic Factor in Patients with Non-Small Cell Lung Cancer
Wooho Ban1, Jongmin Lee1, Jickhwan Ha1, Changdong Yeo2, Hyeonhui Kang1, Chinkook Rhee3, Hwasik Moon1, Sanghaak Lee1
The Catholic University of Korea, St. Paul`s Hospital, Korea1, The Catholic University of Korea, Uijeongbu, St. Mary’s Hospital, Korea2, The Catholic University of Korea, Seoul, St. Mary’s Hospital, Korea3 Background: Non-small cell lung cancer (NSCLC) is one of the most fatal cancers worldwide. Age, performance status and stage are well-known prognostic factors for patients with NSCLC. Dyspnea is a common and distressing symptom in patients with NSCLC, however, the prognostic value of dyspnea remains uncertain.
Methods: We retrospectively reviewed a prospective lung cancer database of St. Paul’s Hospital, The Catholic University of Korea, from 2001 to 2014. Dyspnea using mMRC scales and clinicopathologic parameters were analyzed to identity their prognostic roles.
Results: Total 457 NSCLC patients were enrolled, 259 (56.7%) patients complained of dyspnea at initial presentation. Except 109 (42.1%) patients with unknown mMRC scales, there were 85 (32.8%) patients with mMRC grade 0 or 1, and 65 (25.1%) pa- tients had mMRC grade 2 or higher. Pulmonary function parameters were signifi cantly decreased in patients with dyspnea, compared to those without dyspnea. The median survival for patients with dyspnea was shorter than those without dyspnea (7 vs. 15 months, p < .001). A signifi cant difference in median survival was also found between patients with mMRC grade 0 or 1 and those with mMRC grade 2 or higher (11 vs. 6 months, p < .001). In multivariate analysis, age (HR, 1.60; 95% CI: 1.20–2.14), poor performance status (HR, 3.67; 95% CI: 2.34–5.77), advanced stage (HR, 2.85; 95% CI:
1.93–4.22), FEV1 level (HR, 0.99; 95% CI: 0.99–1.00) and dyspnea of mMRC grade 2 or higher (HR, 1.89; 95% CI: 1.32–2.70) were associated with poor outcome.
Conclusions: These results suggest dyspnea could be an independent prognostic factor for patients with NSCLC. Therefore, clinicians are required to pay more attention to NSCLC patients’ complaining of dyspnea, individually.
