Virtual Library
Start Your Search
Jianming Ying
Author of
-
+
JCSE01 - Joint IASLC-CSCO-CAALC Session (ID 63)
- Event: WCLC 2019
- Type: Joint IASLC-CSCO-CAALC Session
- Track:
- Presentations: 1
- Now Available
- Moderators:Chunxue Bai, Tony Mok, Yi-Long Wu, Qing Zhou, Nan Wu
- Coordinates: 9/07/2019, 07:00 - 11:15, Toronto (1985)
-
+
JCSE01.10 - Efficacy and Safety of Neoadjuvant PD-1 Blockade with Sintilimab in Resectable Non-Small Cell Lung Cancer (Now Available) (ID 3424)
07:00 - 11:15 | Author(s): Jianming Ying
- Abstract
- Presentation
Abstract
Background
NSCLC patients who have potentially resectable disease often subsequently relapse after surgery. New therapy that prevents relapse after surgery is desperately needed. In this study, we tested the efficacy and safety of neoadjuvant sintilimab, an anti-PD-1 antibody, for patients with resectable sqNSCLC in China.
Methods
All patients had treatment-naïve resectable sqNSCLC (stage IB-IIIA) that was confirmed by histopathology. Patients received two cycles of sintilimab (200 mg IV) on Day 1 and 22. Surgery was performed between Day 29-43. An enhanced PET/CT was obtained at baseline and seven days prior to surgery. Preliminary analysis of safety profile and efficacy was planned after at least 20 patients had received operation.
Results
As of Jan. 28, 2019, 22 patients (20 males and 2 females) with sqNSCLC received two doses of sintilimab followed by radical resection. The median age was 61.5 yr (range, 48 to 70). Six (27.3%) and four (18.2%) patients experienced neoadjuvant treatment emergent adverse events (TEAEs) and neoadjuvant treatment-related AEs (TRAEs), respectively. Most of the TEAEs and TRAEs were grade 1 or 2. Three patients achieved radiological partial response: an ORR of 13.6% based on RECIST 1.1. Ten patients (45.5%) achieved a major pathologic response (MPR, ≤10% viable tumor cells), including four (18.2%) had complete pathologic response (no viable tumor cell). There was a direct correlation between pathological response and decrease in the standardized uptake values (SUV) in the primary tumor. Among nine patients with > 30% decrease of SUV, eight had MPR, compared with no MRP response in the 11 patients with ≤30% decrease of SUV.
Conclusion
Neoadjuvant sintilimab for sqNSCLC patients was tolerable and the 45.5% MRP rate is encouraging. A decrease in SUV may be predictive of pathologic response after PD-1 therapy in sqNSCLC.Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
-
+
P1.09 - Pathology (ID 173)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
-
+
P1.09-05 - ALK Testing in Chinese Advanced NSCLC Patients: A National-Wide Multicenter Prospective Real-World Data Study (The RATICAL Study) (ID 1800)
09:45 - 18:00 | Presenting Author(s): Jianming Ying
- Abstract
Background
ALK-tyrosine kinase inhibitors increase ORR and PFS times in ALK-fusion positive NSCLC patients. It is therefore crucial to assess the efficacy of different methods for detecting ALK rearrangement. At present, there are most testing methods approved by cFDA to detect ALK rearrangement in China. However, many issues regarding to the procedure and quality control (QC) data of ALK testing in the routine clinical practice is still to be studied. This study is to evaluate the ALK testing platforms, testing procedures, result interpretation quality control and clinicopathological characteristics of ALK positive patients in the real world for Chinese lung cancer patients, and achieve expert consensus on the clinical practice of ALK testing.
Method
Top 31 hospitals with lung cancer patients in China will participate in the study. All advanced NSCLC subjects who received ALK gene test and all ALK positive NSCLC patients who received surgical treatment from Oct. 2018 to Dec. 2019 will be enrolled. The testing platforms include IHC-Ventana，FISH，RT-PCR and NGS. It is expected to enroll a total of 30,000 cases, and the clinicopathological information of the patients will be collected. Ring study and interpretation training will be conducted before the study initiated. When 2,000 and 10,000 cases are enrolled, the interim summary and quality control will be conducted respectively. The results were the interim summary and quality control results of 2,000 cases.
Result
The 2263 enrollees (mean age, 63 years) included 1365 males (60.32%) and 907 females (39.68%). 205 (of 2263, 9.06%) cases were ALK positive. The ALK positive rate of females (11.10%) was significantly higher than that of males (7.74%). The ALK positive rate of non-smoking patients (11.54%) was significantly higher than that of smoking patients (5.70%). In addition to ALK, the positive rate of EGFR, KRAS, ROS1, HER2, MET, RET and BRAF gene alterations was 46.05%, 9.52%, 3.13%, 3.09%, 2.98%, 2.12% and 0.94%, respectively. Total rate of all driver gene mutation was 60.37% in males, while it was 91.71% in female. Total rate of all driver gene mutation was 59.77% in smoking patients and 90.44% in non-smoking patients. Concurrent mutation of ALK with EGFR, KRAS or ROS1 was 0.33%, 0.45% and 0.22%, respectively. The fusion of EML4-ALK accounted for 75%. The inconsistency rate of IHC-Ventana with FISH, RT-PCR, NGS was 95.07%, 91.30% and 95.45%, respectively. For ALK IHC quality control, 109 slides were used for ring study, and 31 pathologists participated in the interpretion. Among 60 negative cases, 25 cases (41.7%) were diagnosed as positive (false positive) by at least one pathologist. Among 49 positive cases, 12 cases (24.5%) were diagnosed as negative (false negative) by at least one pathologist; 34 cases (31.2%) were diagnosed as inconclusive by at least one pathologist. There were 3.5% and 1.1% of cases found to be misinterpreted during the internal QC and regional QC, respectively.
Conclusion
NSCLC patients harboring ALK gene translocation have unique clinicopathological characteristics. Some problems will still be encountered in the real world clinical practice of ALK testing, which need to be guided by establishment of expert consensus.
-
+
P2.11 - Screening and Early Detection (ID 178)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
-
+
P2.11-31 - DNA Methylation Markers for Prediction of Recurrence in Stage I Non-Small Cell Lung Cancers (Now Available) (ID 2505)
10:15 - 18:15 | Author(s): Jianming Ying
- Abstract
Background
Surgery with curative intent is the standard of care for patients with stage I non-small cell lung cancer (NSCLC). However, many patients die of recurrent disease despite of lesion resection. The value of DNA methylation for predicting the recurrence of early-stage, resected NSCLC remains to be determined. The aim of this study was to find DNA methylation markers for recurrence prediction.
Method
39 paired tumor tissues and adjacent normal tissues from stage Ia NSCLCs were sequenced using bisulfite sequencing panel which covers 80,672 CpG sites and spans 1.05 mega base of human genome. The average sequencing depth was 1000X. Methylation blocks (MBs) were defined as the genomic region between the neighboring CpG sites and 8312 MBs were generated using the linkage disequilibrium and statistical modeling. Methylmean indicates the mean methylation value of MB, and methyentropy denotes the randomness of DNA methylation pattern of MB.
Result
A total of 726 tumor-specific MBs shared by 1098 Methylentropy and 1316 Methylmean variates were obtained from matched tumor tissues and adjacent normal tissues using t-test (P<0.05). Then the multivariable analysis, conducted via the Cox regression model, generated 15 significant disease-free survival (DFS)-related MBs which shared by 56 methylentropy and 46 methylmean variates. A final model was selected using a backward step-down process and 6 significant DFS-related MBs were selected (1 methylentropy and 5 methylmean variates). A nomogram model that incorporated the 6 MBs was established to predict the DFS, and it performed well (C index=0.729, Figure 1).
Conclusion
We established an effective nomogram that may well distinguish the potential subgroup of patients with different DFS based on DNA methylation. Further perspective study should be conducted to validate this nomogram model in larger cohorts.
-
+
P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
-
+
P2.16-08 - Clinical Characteristics and Outcomes of Patients with BRAF Mutated Non-Small Cell Lung Cancer (Now Available) (ID 1106)
10:15 - 18:15 | Author(s): Jianming Ying
- Abstract
Background
BRAF mutation is a driver oncogene identified in 0.5-2% of non-small cell lung cancer (NSCLC) patients in China, and clinical data are relatively inadequate. This study assessed the clinical characteristics, course of disease and treatment outcomes in patients with BRAF mutated NSCLC in a real-world setting.
Method
Between Apr 1, 2017 and Feb 1, 2019, medical data of patients with NSCLC harboring BRAF mutation in our cancer center was retrospective collected. Patient characteristics and treatment outcomes were reviewed. Data cutoff was Apr 1, 2019.
Result
A total of 36 patients were identified. BRAF V600E was the most common (31/36, 86.1%), other BRAF molecular subsets were observed in 5 (13.9%) cases including K601E, G469V, G596R and D594N. The majority of patients with BRAF mutation were female (20/36, 55.6%) and non-smokers (20/36, 55.6%), all of them were adenocarcinoma, and median age at diagnosis was 56 (range, 33-79). Twenty-seven patients were recurrent or metastatic NSCLC at data cutoff, most of whom received chemotherapy (16/27, 59.3%) as first-line therapy with median progression-free survival (PFS) of 9.8 months (95%CI 0.0, 21.5) and disease control rate (DCR) of 68.8% (11/16). Eight patients received anti-BRAF targeted therapy (including dabrafenib, trametinib and vemurafenib) in the first-line and showed superior efficacy than those received chemotherapy (median PFS, 15.9 months [95%CI, 4.5, 27.3] vs. 9.8 months [95%CI, 0.0, 21.5], P = 0.183; DCR, 100% vs. 68.8%, P = 0.130). As for distinct molecular subsets, most patients with V600E mutation were female (19/31, 61.3%) and non-smokers (19/31, 61.3%), while four of five (80.0%) patients with non-V600E mutation were male and smokers. All of the 3 patients in non-V600E mutations subgroup with recurrent or metastatic disease received chemotherapy in the first-line, and achieved 2 of SD, 1 of PD.
Conclusion
NSCLC with BRAF mutation was associated with specific characteristics, which were variable between molecular subsets. BRAF inhibitors should be considered firstly in treating patients with BRAF-mutated lung cancers. The prognosis value of non-V600E mutations and treatment selection needs more research.
