- Email: [email protected]
Biomarker testing of lung cancer in Spain
abstracts
Annals of Oncology Funding (self): Eli Lilly; Research grant / Funding (self): AbbVie; Research grant / Funding (self): Daiichi-Sankyo; Research grant / Funding (self): Bayer; Advisory / Consultancy, Research grant / Funding (self): Boehringer Ingelheim; Research grant / Funding (self): Kyowa-Hakko Kirin; Advisory / Consultancy, Research grant / Funding (self): Takeda; Speaker Bureau / Expert testimony, Research grant / Funding (self): Ono; Research grant / Funding (self): Janssen Pharma; Research grant / Funding (self): MSD; Research grant / Funding (self): Merck; Advisory / Consultancy: Otsuka; Advisory / Consultancy: Cimic. All other authors have declared no conflicts of interest.
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Tobacco use in lung cancer (LC) patients (p) in Spain
Background: Tobacco use, mainly as cigarette smoking, is the leading cause of lung cancer. Eighty-five percent of LC occur in smokers. Understanding the Spanish smoking habits allows the government to design health care policies against this consumption. To do so, the Grupo Espa~ nol de Cancer de Pulm on (Spanish Lung Cancer Group) made this analysis within the context of the Thoracic Tumor Registry (TTR). Methods: The TTR is an observational cohort multicenter study in Spain. The study is conducted according to the Declaration of Helsinki and approved by the institutional review board of each participating site. The registry was approved by the Spanish Drug Agency, as a non-post-authorization, non-interventional study. Results: Data have been collected from 6,600 LC from 58 different hospital sites across Spain. 12% (866 p) were non-smokers, 46% (3,039 p) were former smokers and 39% (2,611 p) were smokers. There were significant differences by gender, more women were non-smokers (37 % vs. 45% in males), meanwhile more former smokers were male (53.4% vs. 27.9% in women) (p-valor < 0.001). Significant differences were also observed in the study on the distribution of the smoking habit by year of diagnosis. In the last two years, the percentage of active smokers increased, both for the total population, as well as, for each one of the two genders separately. The increase was greater among the women and, also, the number of women who are active smokers is greater in recent years. Mean age of onset of the smoking habit was 18.2 years. Mean initiation age was less for men, 17.9 years in the men (95%CI 17.6-18.2 years) and 19.2 years in the women (95%CI 18.5-19.8 years) (p-valor < 0.001). Finally, it was found significant differences between Regional Communities in the mean age at onset of the habit, with much lower levels in the Valencian Community (16.6 years) or Navarra (16.9 years) regarding other regions, such as Murcia (22.9 years) or the Balearic Islands (21.6 years). Conclusions: Tobacco use is the leading cause of LC in Spain accounting 85% of the cases. Consumption has increased in both genders, but specially in women, in our country among lung cancer patients. Tobacco cessation campaigns, especially in women, should be a priority in western countries, like Spain, and it has to be adapted to regional differences in tobacco use. Clinical trial identification: NCT02941458. Legal entity responsible for the study: Spanish Lung Cancer Group. Funding: Novartis, MSD, Lilly. Disclosure: M. Provencio: Advisory / Consultancy: BMS; Advisory / Consultancy, Travel / Accommodation / Expenses: MSD; Advisory / Consultancy, Travel / Accommodation / Expenses: AstraZeneca; Advisory / Consultancy: Boehringer Ingelheim. All other authors have declared no conflicts of interest.
Volume 30 | Supplement 5 | October 2019
Biomarker testing of lung cancer in Spain
D. Rodriguez Abreu1, M. Guirado2, C.J. Camps Herrero3, J. Bosch Barrera4, R. Bernabe´5, J. Casal6, M-R. Garcıa-Campelo7, J.L. Gonzalez-Larriba8, B. Massuti Sureda9, A.L. Ortega Granados10, M. Domine Gomez11, M.A. Sala12, A. Padilla13, E. Del Barco Morillo14, opez Castro18, J.M. Oramas Rodriguez15, R. Blanco Guerrero16, D. Aguiar Bujanda17, R. L E. Carcereny Costa19, M. Provencio20 1 Medical Oncology, Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain, 2 Department of Medical Oncology, Hospital General Universitario de Elche, Elche, Spain, 3Medical Oncology, Hospital General de Valencia, Universidad de Valencia, a d’Oncologia CIBERONC, Valencia, Spain, 4Oncology Department, ICO - Institut Catal Girona (Hospital Universitari Josep Trueta Hospital Universitari Josep Trueta), Girona, 5 Spain, Oncology Department, Hospital Universitario Virgen del Rocıo, Seville, Spain, 6 Dept. Medical Oncology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain, 7 Medical Oncology Department, Complejo Hospitalario Universitario A Coruna (CHUAC), La Coru~ na, Spain, 8Department of Medical Oncology, Hospital Clinico Universitario San Carlos, Madrid, Spain, 9Department of Medical Oncology, Hospital General Universitario de Alicante, Alicante, Spain, 10Oncologıa Me´dica, Complejo Hospitalario de Jaen Universidad de Jaen, Jaen, Spain, 11Department of Medical Oncology, University Hospital "Fundacion Jimenez Diaz", Madrid, Spain, 12Department of Medical Oncology, Hospital de Basurto, Bilbao, Spain, 13Medical Oncology, Hospital Universitario Nuestra Se~ nora de Candelaria, Santa Cruz de Tenerife, Spain, 14 Department of Medical Oncology, Hospital Universitario de Salamancavestigaci on Biome´dica de Salamanca, Salamanca, Spain, 15Department of Medical Oncology, Hospital Universitario de Canarias, San Cristobal de La Laguna, Santa Cruz de Tenerife, Spain, 16Department of Medical Oncology, Hospital Terrassa-Consorci Sanitari de Terrassa, Terrassa, Spain, 17Medical Oncology, Hospital de Gran Canaria Dr. Negrın, Las Palmas, Spain, 18Department of Oncology, Hospital Clınico Universitario de Valladolid, Valladolid, Spain, 19Department of Medical Oncology, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, B-ARGO, IGTP, Badalona, Spain, 20Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain Background: Target therapy guide by biomarkers have become the standard of care for patients with lung cancer (LC). So, identify those molecular alterations is one of the most important care needs nowdays. Our objective was to know the implementation degree of these tests in a large cohort of patients in Spain using the Thoracic Tumor Registry (TTR) of the Grupo Espa~ nol de Cancer de Pulm on (Spanish Lung Cancer Group). Methods: The TTR is an observational cohort multicenter study of LC in Spain. The study is conducted according to the Declaration of Helsinki and approved by the institutional review board of each participating institute. The registry was approved by the Spanish Drug Agency as a non-post-authorization, non-interventional study. We analyzed the molecular biomarkers considering all stages of LC. Results: A total of 7,872 patients from 58 Spanish centers were enrolled between August 2016 to December 2018. The most frequent screened molecular test was the EGFR mutations, it was performed in 4,456 patients (67.5%). The proportion of biomarker evaluation has varied over time, ranging from 57.9% prior to 2012 up to 73.7% in 2017. The molecular assessment of some biomarkers reached 81.4% of these patients, with some differences between Regional Communities, regarding the molecular tests performed. Three thousand four hundred forty-six (3,446) patients (52.2%) had a stage IV at diagnosis. There was performed some biomarker test in 92% of the 2570 patients with stage IV and non-squamous histology. In those stage IV non-squamous patients, the EGFR and ALK test were performed in 92% and 79% respectively but 2 years ago ALK test was done only in 40% of the patients. ROS1 was studied in 20% of the cases. Conclusions: Although no national plan exists for molecular biomarker analysis in Spain, the implementation of biomarkers tests in all the hospitals that contribute to the TTR is high. The increase in the ALK analysis in the last period is relevant. As we have some regional differences, it is important to understand the causes to improve them. Clinical trial identification: NCT02941458. Legal entity responsible for the study: Spanish Lung Cancer Group. Funding: Novartis, Merck Sharp and Dohme, Lilly. Disclosure: All authors have declared no conflicts of interest.
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Mendelian randomization study of Alzheimer’s disease and lung cancer
H. Zhou1, J. Shen2, Y. Zhang1, J. Liu2, Y. Huang1, L. Zhang1 Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China, 2Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
1
Background: Observational studies show that Alzheimer’s disease (AD) and lung cancer is negatively associated in both directions. However, whether there is a causal relationship between AD and lung cancer remains uncertain. Mendelian Randomization (MR) is a novel approach for the assessment of causality, using genome-wide significant single-nucleotide polymorphisms (SNP) as instrument variables (IV) to eliminate the bias caused by confounders. In this study, we utilized a bi-directional two-sample MR analysis to estimate the potential causality between AD and lung cancer. Methods: The genome-wide association study (GWAS) summary data of AD and lung cancer were derived from the International Genomics of Alzheimer’s Project (IGAP,17,008 AD cases and 37,154 controls) and the International Lung Cancer
doi:10.1093/annonc/mdz266 | v749
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz266.005/5578035 by guest on 25 October 2019
E. Carcereny Costa1, M. Guirado2, C.J. Camps Herrero3, J. Bosch Barrera4, M-R. GarcıaCampelo5, A.L. Ortega Granados6, J.L. Gonzalez-Larriba7, N. De Dios Alvare8, M. Domine Gomez9, B. Massuti Sureda10, M.A. Sala11, R. Bernabe´12, J.M. Oramas Rodriguez13, E. del Barco Morillo14, A. Padilla15, D. Aguiar Bujanda16, S. Cerezo Gonzalez17, R. Lopez Castro18, D. Rodriguez Abreu19, M. Provencio20 1 Department of Medical Oncology, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, B-ARGO, IGTP, Barcelona, Spain, 2Department of Medical Oncology, Hospital General Universitario de Elche, Elche, Alicante, Spain, 3Medical Oncology, Hospital General de Valencia, Universidad de Valencia, CIBERONC, Valencia, a d’Oncologia Girona (Hospital Spain, 4Oncology Department, ICO - Institut Catal Universitari Josep Trueta Hospital Universitari Josep Trueta), Girona, Spain, 5Medical Oncology Department, Complejo Hospitalario Universitario A Coruna (CHUAC), La Coru~ na, Spain, 6Department of Medical Oncology, Complejo Hospitalario de Jaen Universidad de Jaen, Jaen, Spain, 7Department of Medical Oncology, Hospital Clinico Universitario San Carlos, Madrid, Spain, 8Department of Medical Oncology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain, 9Department of Medical Oncology, University Hospital "Fundacion Jimenez Diaz", Madrid, Spain, 10Department of Medical Oncology, Hospital General Universitario de Alicante, Alicante, Spain, 11Department of Medical Oncology, Hospital de Basurto, Bilbao, Spain, 12Oncology Department, Hospital Universitario Virgen del Rocıo, Seville, Spain, 13Department of Medical Oncology, Hospital Universitario de Canarias, San Cristobal de La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain, 14Department of Medical Oncology, Hospital Universitario de Salamanca, Salamanca, Spain, 15Medical Oncology, Hospital Universitario Nuestra Se~ nora de Candelaria, Santa Cruz de Tenerife, Spain, 16Medical Oncology, Hospital de Gran Canaria Dr. Negrın, Las Palmas, Spain, 17Department of Medical Oncology, Hospital General Mancha Centro, Alcazar de San Juan, Spain, 18Radiation and Medical Oncology, University Clinical Hospital of Valladolid, Valladolid, Spain, 19Medical Oncology, Hospital Universitario Insular de Gran Canaria, Las Palmas, Canary Islands, Spain, 20Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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Annals of Oncology Funding (self): Eli Lilly; Research grant / Funding (self): AbbVie; Research grant / Funding (self): Daiichi-Sankyo; Research grant / Funding (self): Bayer; Advisory / Consultancy, Research grant / Funding (self): Boehringer Ingelheim; Research grant / Funding (self): Kyowa-Hakko Kirin; Advisory / Consultancy, Research grant / Funding (self): Takeda; Speaker Bureau / Expert testimony, Research grant / Funding (self): Ono; Research grant / Funding (self): Janssen Pharma; Research grant / Funding (self): MSD; Research grant / Funding (self): Merck; Advisory / Consultancy: Otsuka; Advisory / Consultancy: Cimic. All other authors have declared no conflicts of interest.
1845P
Tobacco use in lung cancer (LC) patients (p) in Spain
Background: Tobacco use, mainly as cigarette smoking, is the leading cause of lung cancer. Eighty-five percent of LC occur in smokers. Understanding the Spanish smoking habits allows the government to design health care policies against this consumption. To do so, the Grupo Espa~ nol de Cancer de Pulm on (Spanish Lung Cancer Group) made this analysis within the context of the Thoracic Tumor Registry (TTR). Methods: The TTR is an observational cohort multicenter study in Spain. The study is conducted according to the Declaration of Helsinki and approved by the institutional review board of each participating site. The registry was approved by the Spanish Drug Agency, as a non-post-authorization, non-interventional study. Results: Data have been collected from 6,600 LC from 58 different hospital sites across Spain. 12% (866 p) were non-smokers, 46% (3,039 p) were former smokers and 39% (2,611 p) were smokers. There were significant differences by gender, more women were non-smokers (37 % vs. 45% in males), meanwhile more former smokers were male (53.4% vs. 27.9% in women) (p-valor < 0.001). Significant differences were also observed in the study on the distribution of the smoking habit by year of diagnosis. In the last two years, the percentage of active smokers increased, both for the total population, as well as, for each one of the two genders separately. The increase was greater among the women and, also, the number of women who are active smokers is greater in recent years. Mean age of onset of the smoking habit was 18.2 years. Mean initiation age was less for men, 17.9 years in the men (95%CI 17.6-18.2 years) and 19.2 years in the women (95%CI 18.5-19.8 years) (p-valor < 0.001). Finally, it was found significant differences between Regional Communities in the mean age at onset of the habit, with much lower levels in the Valencian Community (16.6 years) or Navarra (16.9 years) regarding other regions, such as Murcia (22.9 years) or the Balearic Islands (21.6 years). Conclusions: Tobacco use is the leading cause of LC in Spain accounting 85% of the cases. Consumption has increased in both genders, but specially in women, in our country among lung cancer patients. Tobacco cessation campaigns, especially in women, should be a priority in western countries, like Spain, and it has to be adapted to regional differences in tobacco use. Clinical trial identification: NCT02941458. Legal entity responsible for the study: Spanish Lung Cancer Group. Funding: Novartis, MSD, Lilly. Disclosure: M. Provencio: Advisory / Consultancy: BMS; Advisory / Consultancy, Travel / Accommodation / Expenses: MSD; Advisory / Consultancy, Travel / Accommodation / Expenses: AstraZeneca; Advisory / Consultancy: Boehringer Ingelheim. All other authors have declared no conflicts of interest.
Volume 30 | Supplement 5 | October 2019
Biomarker testing of lung cancer in Spain
D. Rodriguez Abreu1, M. Guirado2, C.J. Camps Herrero3, J. Bosch Barrera4, R. Bernabe´5, J. Casal6, M-R. Garcıa-Campelo7, J.L. Gonzalez-Larriba8, B. Massuti Sureda9, A.L. Ortega Granados10, M. Domine Gomez11, M.A. Sala12, A. Padilla13, E. Del Barco Morillo14, opez Castro18, J.M. Oramas Rodriguez15, R. Blanco Guerrero16, D. Aguiar Bujanda17, R. L E. Carcereny Costa19, M. Provencio20 1 Medical Oncology, Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain, 2 Department of Medical Oncology, Hospital General Universitario de Elche, Elche, Spain, 3Medical Oncology, Hospital General de Valencia, Universidad de Valencia, a d’Oncologia CIBERONC, Valencia, Spain, 4Oncology Department, ICO - Institut Catal Girona (Hospital Universitari Josep Trueta Hospital Universitari Josep Trueta), Girona, 5 Spain, Oncology Department, Hospital Universitario Virgen del Rocıo, Seville, Spain, 6 Dept. Medical Oncology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain, 7 Medical Oncology Department, Complejo Hospitalario Universitario A Coruna (CHUAC), La Coru~ na, Spain, 8Department of Medical Oncology, Hospital Clinico Universitario San Carlos, Madrid, Spain, 9Department of Medical Oncology, Hospital General Universitario de Alicante, Alicante, Spain, 10Oncologıa Me´dica, Complejo Hospitalario de Jaen Universidad de Jaen, Jaen, Spain, 11Department of Medical Oncology, University Hospital "Fundacion Jimenez Diaz", Madrid, Spain, 12Department of Medical Oncology, Hospital de Basurto, Bilbao, Spain, 13Medical Oncology, Hospital Universitario Nuestra Se~ nora de Candelaria, Santa Cruz de Tenerife, Spain, 14 Department of Medical Oncology, Hospital Universitario de Salamancavestigaci on Biome´dica de Salamanca, Salamanca, Spain, 15Department of Medical Oncology, Hospital Universitario de Canarias, San Cristobal de La Laguna, Santa Cruz de Tenerife, Spain, 16Department of Medical Oncology, Hospital Terrassa-Consorci Sanitari de Terrassa, Terrassa, Spain, 17Medical Oncology, Hospital de Gran Canaria Dr. Negrın, Las Palmas, Spain, 18Department of Oncology, Hospital Clınico Universitario de Valladolid, Valladolid, Spain, 19Department of Medical Oncology, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, B-ARGO, IGTP, Badalona, Spain, 20Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain Background: Target therapy guide by biomarkers have become the standard of care for patients with lung cancer (LC). So, identify those molecular alterations is one of the most important care needs nowdays. Our objective was to know the implementation degree of these tests in a large cohort of patients in Spain using the Thoracic Tumor Registry (TTR) of the Grupo Espa~ nol de Cancer de Pulm on (Spanish Lung Cancer Group). Methods: The TTR is an observational cohort multicenter study of LC in Spain. The study is conducted according to the Declaration of Helsinki and approved by the institutional review board of each participating institute. The registry was approved by the Spanish Drug Agency as a non-post-authorization, non-interventional study. We analyzed the molecular biomarkers considering all stages of LC. Results: A total of 7,872 patients from 58 Spanish centers were enrolled between August 2016 to December 2018. The most frequent screened molecular test was the EGFR mutations, it was performed in 4,456 patients (67.5%). The proportion of biomarker evaluation has varied over time, ranging from 57.9% prior to 2012 up to 73.7% in 2017. The molecular assessment of some biomarkers reached 81.4% of these patients, with some differences between Regional Communities, regarding the molecular tests performed. Three thousand four hundred forty-six (3,446) patients (52.2%) had a stage IV at diagnosis. There was performed some biomarker test in 92% of the 2570 patients with stage IV and non-squamous histology. In those stage IV non-squamous patients, the EGFR and ALK test were performed in 92% and 79% respectively but 2 years ago ALK test was done only in 40% of the patients. ROS1 was studied in 20% of the cases. Conclusions: Although no national plan exists for molecular biomarker analysis in Spain, the implementation of biomarkers tests in all the hospitals that contribute to the TTR is high. The increase in the ALK analysis in the last period is relevant. As we have some regional differences, it is important to understand the causes to improve them. Clinical trial identification: NCT02941458. Legal entity responsible for the study: Spanish Lung Cancer Group. Funding: Novartis, Merck Sharp and Dohme, Lilly. Disclosure: All authors have declared no conflicts of interest.
1847P
Mendelian randomization study of Alzheimer’s disease and lung cancer
H. Zhou1, J. Shen2, Y. Zhang1, J. Liu2, Y. Huang1, L. Zhang1 Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China, 2Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
1
Background: Observational studies show that Alzheimer’s disease (AD) and lung cancer is negatively associated in both directions. However, whether there is a causal relationship between AD and lung cancer remains uncertain. Mendelian Randomization (MR) is a novel approach for the assessment of causality, using genome-wide significant single-nucleotide polymorphisms (SNP) as instrument variables (IV) to eliminate the bias caused by confounders. In this study, we utilized a bi-directional two-sample MR analysis to estimate the potential causality between AD and lung cancer. Methods: The genome-wide association study (GWAS) summary data of AD and lung cancer were derived from the International Genomics of Alzheimer’s Project (IGAP,17,008 AD cases and 37,154 controls) and the International Lung Cancer
doi:10.1093/annonc/mdz266 | v749
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz266.005/5578035 by guest on 25 October 2019
E. Carcereny Costa1, M. Guirado2, C.J. Camps Herrero3, J. Bosch Barrera4, M-R. GarcıaCampelo5, A.L. Ortega Granados6, J.L. Gonzalez-Larriba7, N. De Dios Alvare8, M. Domine Gomez9, B. Massuti Sureda10, M.A. Sala11, R. Bernabe´12, J.M. Oramas Rodriguez13, E. del Barco Morillo14, A. Padilla15, D. Aguiar Bujanda16, S. Cerezo Gonzalez17, R. Lopez Castro18, D. Rodriguez Abreu19, M. Provencio20 1 Department of Medical Oncology, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, B-ARGO, IGTP, Barcelona, Spain, 2Department of Medical Oncology, Hospital General Universitario de Elche, Elche, Alicante, Spain, 3Medical Oncology, Hospital General de Valencia, Universidad de Valencia, CIBERONC, Valencia, a d’Oncologia Girona (Hospital Spain, 4Oncology Department, ICO - Institut Catal Universitari Josep Trueta Hospital Universitari Josep Trueta), Girona, Spain, 5Medical Oncology Department, Complejo Hospitalario Universitario A Coruna (CHUAC), La Coru~ na, Spain, 6Department of Medical Oncology, Complejo Hospitalario de Jaen Universidad de Jaen, Jaen, Spain, 7Department of Medical Oncology, Hospital Clinico Universitario San Carlos, Madrid, Spain, 8Department of Medical Oncology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain, 9Department of Medical Oncology, University Hospital "Fundacion Jimenez Diaz", Madrid, Spain, 10Department of Medical Oncology, Hospital General Universitario de Alicante, Alicante, Spain, 11Department of Medical Oncology, Hospital de Basurto, Bilbao, Spain, 12Oncology Department, Hospital Universitario Virgen del Rocıo, Seville, Spain, 13Department of Medical Oncology, Hospital Universitario de Canarias, San Cristobal de La Laguna, Santa Cruz de Tenerife, Canary Islands, Spain, 14Department of Medical Oncology, Hospital Universitario de Salamanca, Salamanca, Spain, 15Medical Oncology, Hospital Universitario Nuestra Se~ nora de Candelaria, Santa Cruz de Tenerife, Spain, 16Medical Oncology, Hospital de Gran Canaria Dr. Negrın, Las Palmas, Spain, 17Department of Medical Oncology, Hospital General Mancha Centro, Alcazar de San Juan, Spain, 18Radiation and Medical Oncology, University Clinical Hospital of Valladolid, Valladolid, Spain, 19Medical Oncology, Hospital Universitario Insular de Gran Canaria, Las Palmas, Canary Islands, Spain, 20Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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