ECTS2016 Cancer and Bone Oral Communications Oral Communications (18 abstracts)
Bone and metabolic parameters are associated with overall survival in patients with bone metastases from adenocarcinoma lung cancer: the POUMOS study
Cyrille B. Confavreux 1, , Lauriane Chambard 1, , Edouard Ollier 3 , Marie Brevet 4 , François Duboeuf 1 , Jean-Charles Rousseau 1 , Jean-Baptiste Pialat 1, , Julien Wegrzyn 1, , Agnès Tescaru 7 , Pawel Szulc 1 , Marie-Christine Carlier 8 , Nicolas Girard 9 & Philippe Clézardin 1
1INSERM UMR1033 – Lyos- Université de Lyon, Lyon, France; 2Department of Rheumatology, Hospices Civils de Lyon, Lyon, France; 3Department of Biostatistics, Hospices Civils de Lyon, Lyon, France; 4Department of Pathology, Hospices Civils de Lyon, Lyon, France; 5Department of Radiology, Hospices Civils de Lyon, Lyon, France; 6Department of Orthopedic Surgery, Hospices Civils de Lyon, Lyon, France; 7Department of Nuclear Medicine, Hospices Civils de Lyon, Lyon, France; 8Department of Clinical Biochemistry, Hospices Civils de Lyon, Lyon, France; 9Department of Pneumology, Hospices Civils de Lyon, Lyon, France.
Rational: Mortality due to non-small cell lung cancers is the first cause of cancer death in men around the world. Lung adenocarcinoma regularly induces bone metastases responsible for high morbidity and impaired life quality. Overall survival of these patients is poor. Thus we aimed to identify if some bone and metabolic parameters were associated with overall survival.
Patients and Methods: POUMOS is a prospective cohort of patients suffering from adenocarcinoma lung cancers with a first bone metastasis (stage IV). All patients had a bone biopsy with molecular status characterization of the tumor for EGFR, KRAS, BRAF and ALK. Bone metastasis localizations were obtained by bone scintigraphy or FDG-PET/CT. Whole body composition was obtained by DEXA scan (Hologic®): including bone mineral density and appendicular lean mass/height2 (ALM index). We assessed fasting blood levels of glycated haemoglobin (HbA1C), calcemia, CTX and DKK1 (ELISA Teco®). Survival analyses were performed using a proportional hazard regression model.
Results: Between 2011 and 2014, we included 64 patients (75% men), aged 65±11. Median survival was 30.5 weeks. There were 54 (84%) smokers, 39 (61%) had a good performance status (PS=0/1). Liver and surrenal metastases were found in 19 (30%) and 20 (31%) patients. Molecular biology of the tumor revealed 9 (14%) EGFR and 11 (17%) KRAS mutations. Eighty percent of patients received combined chemotherapy. More than a half of patients had >5 bone lesions and 41% had a weight-bearing bone involvement. Smoking, PS>2, weight-bearing bone involvement, >5 localizations, hypercalcemia, elevated DKK1, elevated white cells, low ALM index and low HbA1C were significantly associated with poor overall survival.
Conclusion: In lung cancer patients with bone metastases, beside common prognostic factors, bone and metabolic parameters are independently associated with overall survival, suggesting that cares dedicated to bone metastases may be essential to improve prognosis.
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ISSN 2052-1219 (online)
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