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Christian Diego Rolfo



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    IASLC Pre-Conference School of Thoracic Oncology (ID 1)

    • Event: LALCA 2019
    • Type: Invited Speaker Session
    • Track:
    • Presentations: 4
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      PC1.08 - A Grant: How to Get it? (ID 8)

      09:00 - 15:30  |  Author(s): Christian Diego Rolfo

      • Abstract
      • Slides

      Abstract not provided

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      PC1.09 - Publish Your Research: Knowing the Process (ID 9)

      09:00 - 15:30  |  Author(s): Christian Diego Rolfo

      • Abstract
      • Slides

      Abstract not provided

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      PC1.12 - Time Management - Learning to Say No (ID 12)

      09:00 - 15:30  |  Author(s): Christian Diego Rolfo

      • Abstract
      • Slides

      Abstract not provided

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      PC1.14 - My First Contract as Faculty: How to Survive Academic Centers (ID 14)

      09:00 - 15:30  |  Author(s): Christian Diego Rolfo

      • Abstract
      • Slides

      Abstract not provided

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    Session 12: Presidential Symposium (ID 27)

    • Event: LALCA 2019
    • Type: Oral Abstract Session
    • Track:
    • Presentations: 1
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      S2.01 - Challenges of Interpreting NGS Liquid Biopsy (LB) Results in Advanced NSCLC: Are ESCAT and OncoKB Scales Reliable? (ID 105)

      09:15 - 09:50  |  Author(s): Christian Diego Rolfo

      • Abstract
      • Slides

      Background:
      Plasma genotyping through next generation sequencing (NGS) is entering clinical practice in NSCLC. Several commercially available platforms can identify a wide variety of somatic aberrations. The correct interpretation of these results can be challenging and vendors include therapeutic suggestions to guide oncologists. Novel levels of evidence tools have been developed to rank genomic alterations in tissue, but not still used in LB.

      Method:
      Advanced NSCLC patients underwent commercial 73-gene cfDNA NGS analysis. ESMO Scale for Clinical Actionability (ESCAT) and OncoKB were used to grade levels of evidence for categorize aberrations and compared with variant allele frequency (VAF), treatment decisions, and vendor suggestions.

      Results:
      77 samples from 73 advanced NSCLC patients at the time of diagnosis (49%) or during disease course (51%) were analyzed. Median turnaround time was 8 days (range 5-17), with no genotyping failures. cfDNA NGS analysis revealed 323 unique somatic alternations. According to ESCAT (IA-IV) and OncoKB (1-4), 87 and 88 genetic alterations were potentially actionable, respectively, and 26% received a matched targeted drug. Discrepancies between these two tools and vendor suggestions were reported in 4 cases (Fig. 1). We performed a subset analysis of 64 samples: Median VAF was 4.37 % (range 0.16-43.05) and a VAF < 1% was reported in 16 samples; 45% of alterations (excluding amplifications) were clonal events (cfDNA% divided by VAF > 0.5). Among EGFR and ALK positive samples median VAF was 7.98% (range 0.29-41.2); 3/17 samples presented a VAF below 1%, with no detrimental effect on treatment response.

      Conclusion:
      The application of ESCAT and OncoKB is feasible in LB. Discrepancies between vendor therapeutic suggestions and evidence-based grading systems requests caution in the use of information outside the molecular tumor board. Driver mutations with low VAF are amenable to receive treatment. VAF could be included as complementary tool to grading systems to better understand the significance of aberrations.

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    Session 13: Targeted Therapy (ID 32)

    • Event: LALCA 2019
    • Type: Invited Speaker Session
    • Track:
    • Presentations: 1
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      S3.04 - ROS-1 Translocations (ID 112)

      14:00 - 15:45  |  Author(s): Christian Diego Rolfo

      • Abstract
      • Slides

      Abstract not provided

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