January 2017 Abstracts S681

Background: Bone metastases (BM) are common (up to

50% of cases) in patients with advanced non-small cell P1.06-026
lung cancer (NSCLC) and other malignancies, including Adenosquamous Carcinoma of the Lung:
prostate cancer and breast cancer (BC). In patients with A Single Institution Experience in the
BMs, the onset of skeletal-related events (SREs), such as Era of Molecular Testing
pathological fracture, malignant hypercalcemia, or spinal
cord compression requiring surgery or radiation ther- Topic: Advanced General
apy, seriously affects the quality of life of patients and
overall survival. The purpose of this study was to Kamal Kishore Mandalapu Hematology and Oncology,
analyze the risk factors (RFs) for development of SREs in Merit Health Biloxi., Biloxi/MS/United States of America
women with advanced NSCLC and BC, with the aim of Background: Adenosquamous carcinoma (ADS) lung is
highlighting the differences (if any) between the two rare subtype of non-small cell lung cancer (NSCLC) that
groups of patients. compromises 0.4-4% of all lung cancers and is thought
Methods: The medical records of 16 women with BMs to carry a worse prognosis than adenocarcinoma (AD) or
from NSCLC (Group A) and 15 women with BMs from squamous cell carcinoma (SC). Epidermal growth factor
luminal-type BC (Group B) were reviewed. The following receptor (EGFR) and Anaplastic Lymphoma Kinase (ALK)
RFs have been considered: age >65 years, ECOG per- mutations have been observed in patients (pts) with this
formance status (PS) <2, the presence of extra-skeletal rare subtype. In the recent years EGFR tyrosine kinase
metastases (ESM) or hypercalcemia (>2.65 mmol/L), inhibitors (Gefitinib, Afatinib and Erlotinib) and ALK in-
and number of BMs >1. Odds ratio (OR) estimates and hibitors (Critzotinib, Ceritinib) have prolonged progres-
the relative 95% confidence interval (CI) were calcu- sion free survival in high-stage adenocarcinomas of the
lated. A p-value level <0.05 was considered statistically lung. The current NCCN guidelines recommend EGFR
significant. and ALK mutation testing in metastatic ADS lung cancer
Results: During follow-up, 5 (33.3%) Group A and 111 patients. However the frequency of these mutations as
(68.7%) Group B patients developed SREs (OR¼4.40, well as outcomes of patients with ADS lung is not known
p¼0.04), respectively. The results are reported in the in this era of targeted therapies.
Table. No significant difference (p¼NS) was found be- Methods: We retrospectively identified all pts seen in
tween groups in relation to ECOG-PS, ESM or hypercal- our oncology clinic for ADS during the last 10 years (1/
cemia, and number of BMs. Only the age >65 years 1/2005 - 1/1/2015). Overall survival (OS) was esti-
(OR¼0.22, p¼0.04) represented a weak significant risk mated by Kaplan-Meier methods.
factor. Results: 16 pts were identified, median age at diag-
nosis was 71y (52-85y), 63% male, 81% had a smoking
history, 87% had ECOG performance status 0-1. 37%
Parameter NSCLC BC OR 95% CI p-value
had Stage I, 18% had stage II, 18% had stage III and
No. of patients 15 16 - - - 25% had stage IV disease at diagnosis, 13% developed
Skeletal-related 33.3% 68.7% 4.40 0.97-19.85 0.04
metastatic disease after treatment for stage III disease.
events
Age >65 years 73.3% 37.5% 0.22 0.05-1.01 0.04
75% of pts diagnosed with metastatic disease after
ECOG-Performance 40.0% 18.8% 0.34 0.07-1.76 0.25 2012 were tested for EGFR and ALK, while none
status >2 diagnosed prior to 2012 were tested. All pts were
Extra-skeletal 26.7% 43.7% 2.14 0.47-9.70 0.32 negative for EGFR and ALK mutations. All pts with
metastases Stage I and II received only surgery; pts with stage III
Malignant 26.7% 12.5% 0.39 0.06-2.55 0.39
hypercalcemia
got multimodality treatment with chemotherapy, radi-
Multiple bone 53.5% 37.5% 0.52 0.12-2.20 0.38 ation, and surgery. All the pts with metastatic disease
metastases received chemotherapy, with regimens similar to those
for AD or SC of lung. The median OS for pts with
localized disease was 48.3 months (48.0- NA). The
Conclusion: Women with BMs from NSCLC has a median OS for pts with metastatic disease was 5.4
reduced risk for development of SREs compared to those months (2.3-9.2).
with BC, but elderly (>65 years) patients require a Conclusion: Our small analysis showed that pts with
closer surveillance, and a precocious bisphosphonate localized ADS of lung had similar outcomes to those of
treatment could be suggested. historical pts with localized AD or SC of the lung. How-
Keywords: bone metastases, Skeletal-related events, ever, pts with metastatic ADS of the lung had worse
NSCLC outcomes than historical pts with metastatic AD or SC of
S682
the lung even with similar chemotherapy regimens. Few
pts had EGFR and ALK testing, but this is becoming more
routine as we have better targeted therapies if they carry
mutation.
Keywords: Targeted Therapies, adenosquamous carci-
noma, Anaplastic Lymphoma Kinase (ALK) mutations,
Epidermal growth factor receptor (EGFR) mutations
P1.06-027
Retrospective Study of Treatment for
Postoperative Local Recurrence
of Lung Cancer
Topic: Advanced General
Kenjiro Tsuruoka,1 Keiji Miyoshi,2
Ninso Matsunaga,2 Takahiko Nakamura,2
Shuhei Yoshida,2 Yousuke Tamura,2
Masafumi Imanishi,2 Soichiro Ikeda,2
Yasuhito Fujisaka,2 Isao Goto2 1Division of Respiratory
Medicine and Thoracic Oncology, Osaka Medical College
Hospital, Osaka/Japan, 2Osaka Medical College Hospital,
Osaka/Japan
Background: There is no consensus regarding the
standard treatment for postoperative local recurrence of
lung cancer. In order to clarify the impact of differences
in treatment on patient survival, we conducted a retro-
spective study of treatment outcomes for patients with
postoperative local recurrence of lung cancer.
Methods: The subjects of this study were patients who
were diagnosed with postoperative local recurrence of
lung cancer and treated at our hospital from 2008 to
2014. We divided patients according to treatment
regimen, and compared patient characteristics and
survival.
Results: This study included 38 patients. Among them, 8
received radiation therapy (RT), 10 received chemo-
radiation therapy (CRT), 18 received chemotherapy (CT),
and 2 received best supportive care. The patient char-
acteristics were as follows: median age (range), 71 years
(55e84); gender male/female, 30/8; pStage at operation
IA/IB/IIA/IIB/IIIA/IIIB, 9/6/9/8/5/1; histology small
cell carcinoma/squamous cell carcinoma/adenocarci-
noma, 5/12/21. There were no significant differences in
patient characteristics between each treatment group.
The proportion of patients who experienced disease
progression after treatment was 75.0% (6/8) in the RT
group, 20.0% (2/10) in the CRT group, and 77.8% (14/
18) in the CT group. Progression free survival (PFS)
tended to be better in the CRT group than in the other
treatment groups. The differences in median PFS
Journal of Thoracic Oncology Vol. 12 No. 1S
(months) were; RT vs CRT: 8.0 vs 15.5, HR¼0.210 (95%
CI 0.042-1.047), P¼0.057; CRT vs CT: 15.5 vs 14.0,
HR¼0.206 (95%CI 0.047-0.908), P¼0.037.
Conclusion: In patients with postoperative local recur-
rence of lung cancer, CRT yielded better outcomes than
the other treatments in terms of PFS.
Keywords: postoperative, recurrence, relapse, local
P1.06-028
Description of the Patients with
Advanced Squamous NSCLC Treated
in a Single Institution
Topic: Advanced General
Irene Torres,1 Joaquín Gimeno,1 Isabel Pajares,1
Ana Comin,1 Jorge Hernando,1 Pilar Felices,1
Ana Nuño,1 Esther Millastre,1 Ana Viñaras,2
Angel Artal Cortes1 1Medical Oncology, Hospital
Universitario Miguel Servet, Zaragoza/Spain, 2Pharmacy,
Hospital Universitario Miguel Servet, Zaragoza/Spain
Background: Squamous carcinomas are a distinct
subtype of NSCLC. Even if it is no longer the most
frequent one, still remains a significant percentage of
NSCLC patients in our practice. Besides, clinical pre-
sentation, associated comorbidities and available ther-
apies are different for non-squamous subtypes.
Assessing their characteristics may help to optimize
therapy.
Methods: Data from patients with a diagnosis of
advanced (stage IV patients plus patients with lower
stages but not amenable for any local therapy) squamous
NSCLand treated in our Hospital between 2009 and
2015 were reviewed.
Results: 209 patients (p) were found. Median age was
69 years (40-89). Gender: Male in 89.5%. PS: ECOG
0¼ 9.1%, 1¼ 45.9%, 2¼ 38.3%, 3¼ 6.7%. By stage, I¼
0.5%, II 3.4%, III 27.7%, IV 68.7%. Therapy: 29.1% of p
did not receive any systemic therapy and 70.9% receive
chemotherapy (CT). CT included a platinum in 69p
(carboplatin 47p, cisplatin 22p) and 61p received a non-
platinum scheme (gemcitabine-vinorelbine 21p, mono-
therapy 40 p (gemcitabine 8p, oral vinorelbine 23p,
other 9p). Patients with better PS (p<0.001) and stage
less than IV (0.02) were more probable to receive CT and
also that CT given included platinum. Overall survival
(OS) was 6.5 months (5.4-7.6) for the whole group. For
stage IV patients, it was significantly shorter: 5.4 months
(p¼0.03). OS for patients not receiving therapy was 2.7m
(vs 7.7m in those treated). Within stage IV OS was
shorter for female vs male (4.2 vs 5.8m), and decreased