Conclusion:The T790M mutation was the most frequent mechanism of TKI resistance. Non-smokers developed the mutation more often than ex-smokers, although this result was not statistically significant. In the other analyzed variables there were no statistically significant differences.

study examined factors predicting favorable survival outcomes among relapsed SCLC patients seen at the Tom Taker Cancer Centre, Alberta Canada. Method: Retrospective analyses were conducted on clinical data of SCLC patients retrieved from the Glans-Look Lung Cancer database. All SCLC patients diagnosed between 2010 and 2016 who completed 4 cycles of 1 st line platin doublets or single-agent etoposide and then relapsed during or after their initial treatments were included. The characteristics of patients relapsing 90 versus <90 days were compared using the Fisher Exact test. The overall survival (OS) was estimated using the Kaplan Meier survival and multivariate Cox Proportional Hazard model. Result: 190 SCLC patients were identified, of which 68% were extensive stage (ES), 57% were female, and 98% were smokers (Ex or current), with a median age of 67 at diagnosis. Most patients relapsed in 90 days: 57/60 (95%) for Limited stage (LS) and 102/130 (79%) for ES (p ¼ 0.003). 48% of LS and 45% of ES received 2 nd line systemic treatment (2L). In ES, receiving 2L cisplatin/etoposide was associated with better survival compared to not receiving 2L (HR¼0.426, p¼0.016) and having a longer relapse interval (90 days) was also associated with better survival (HR¼0.539, p¼0.015). Stratifying by relapse intervals, receiving 2L was associated with better survival in both the 90 (445 vs 286 days, p ¼ 0.049) and <90 days (301 vs 219 days, p ¼ 0.059) strata. In LS, favorable OS was associated with initial thoracic radiation (RT) receipt (HR¼0.237, p¼0.024) and no distant metastases (DM) at relapse (HR¼0.257, p¼0.005). Also of note, 83% LS and 21% ES had RT (p < 0.001) and at relapse, 52% LS and 92% ES had distant metastases. Conclusion: The median OS in relapsed SCLC is low but is at least improved with 2L receipt in relapsed ES patients irrespective of the time to relapse (90 or <90 days). Hence, more effective therapy is required for these patients.

data of patient characteristics, histology, performance status (PS), stage, metastatic sites, smoking history, driver mutation, PD-L1 expression, treatment line from medical records. Progression-free survival(PFS) of pembrolizumab and Overall survival(OS) was calculated using Kaplan-Meier method. We compared PFS according to PD-L1 expression using log rank test and Cox model was used to assess the effect of PD-L1 expression on PFS. Patients were stratified into 2 PD-L1 groups based on PD-L1 expression: medium-high expression (TPS 50-74%), and very high expression (TPS 75-100%). Result: The median age was 74 years (range: 43-86) and 15% of patients were women. The metastatic sites were brain (17%), pleural effusion (27%), bone (39%), liver (7%). The 22% of patients previously treated with chemotherapy and 78% of patients was treatment-naive. Median PFS of all patients was 7.0 months (CI95%. 4.2-16 months) and, median OS of all patients was not reached, respectively. In log-lank test, sex, smoking history, brain metastasis, pleural effusion, driver mutation, and PD-L1 expression were associated with PFS. In multivariate analysis using Cox model, only PD-L1 very high expression was associated with good prognosis (HR: 0.37, CI95%: 0.14-1.00). Conclusion: Even in cohort of PD-L1 TPS of 50% or greater, PD-L1 very high expression was predictive marker of pembrolizumab monotherapy.

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