Author of

• 16722

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  P1.04 - Poster Session with Presenters Present (ID 456)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Pulmonology
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16725

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    P1.04-003 - Incidence of Non-Caseating Granulomas Diagnosed in PET Avid Mediastinal/Hilar Nodes in Patients with Known Breast Cancer (ID 4189)

    14:30 - 15:45  |  Author(s): D. Miller
    • Abstract

    Background:
    Breast cancer is known to metastasize to the lung.. Most breast malignancies are clinically staged using radiographic modalities (e.g. PET scans). Importantly, many inflammatory disorders will present similar lymph node FDG-uptake on PET- as that of metastasized breast cancer. The latter confuses the treatment for individuals within whom both undiagnosed autoimmune disorders and breast cancer co-occur. We aim to examine the frequency of non-caseating granulomas diagnosed in PET avid mediastinal/hilar nodes in patients with known breast cancer.
    
    Methods:
    Between March 2013 and December 2015, 46 patients diagnosed with breast cancer were staged by PET-CT. Those with positive result in the mediastinum/hilum underwent linear endobronchial ultrasound (EBUS) for pathologic diagnosis and ensuing treatment
    
    Results:
    Of the 46 patients with avid mediastinal/hilar adenopathy, 31 (67%) had malignant cytology on EBUS; the remaining 15 had positive PET but negative cytology for malignancy. Twelve of the 15 patients with false positive PET had reactive lymph nodes, and 3 had non-caseating granulomas on cytology (table 1). . Table 1: Results from EBUS Procedure and Resulting Percentage Following Identification of Sarcoid-like Symptoms

    Total Number of patients in study: n=46 with positive PET	Number of patients	Percentage of total (all PET positive patients)	Percentage among negative patients
    Positive EBUS	31	67.40%
    Negative EBUS	12	26.10%	80%
    Negative/Non-caseating granulomas EBUS	3	6.50%	20%

    Twenty percent of the patients with negative cytology and positive PET had non-caseating granuloma, and 6.5 % of all patients with positive PET had non-caseating granulomas.
    
    Conclusion:
    Conclusion: This study represents the largest cohort of breast cancer patients, where the incidence of non-caseating granulomas is investigated in PET-positive mediastinal/hilar nodes. We conclude that PET may not be sufficient for staging the mediastinum in patients with breast cancer and, in selected patients, pathologic staging should be done. In addition, the finding of non-caseating granulomas in these patients may either indicate an incidental diagnosis of early stage sarcoidosis, or an inflammatory reaction to the current treatment (sarcomatoid reaction). We also suggest that these patients should be followed for any manifestations of sarcoidosis.
    
    

• 16879

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  P1.07 - Poster Session with Presenters Present (ID 459)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: SCLC/Neuroendocrine Tumors
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16911

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    P1.07-032 - Most Common Genomic Alterations in SCLC (ID 5112)

    14:30 - 15:45  |  Author(s): D. Miller
    • Abstract

    Background:
    Lung cancer is the leading cause of cancer death in US. The American Cancer Society’s estimates for lung cancer in the United States for 2016 are: approx 224,390 new cases of lung cancer and approx 158,080 deaths. Approximately 10-15% of lung cancers are classified as small cell (SCLC). These cancers portend a poor prognosis. Genomic sequencing of non-small cell lung cancer led to developing of new therapeutic modalities, i.e. targeted therapy with superior results to conventional cytotoxic chemotherapy. At this time, there is no approved targeted therapy for SCLC. In order to develop targeted therapies we need to identify and characterize molecular targets (alterations). This study aims to report our experience with genomic sequencing of SCLC
    
    Methods:
    We performed a retrospective analysis of a dataset of 54 cases of SCLC, who underwent genomic sequencing. Patients were treated at 5 tertiary referral centers, between October 2012 and June 2016. The recorded data included: age at diagnosis, date of the genomic sequencing, genomic alteration (affected genes and the type of molecular alteration identified). For genomic profiling we used a platform commercially available (FoundationOne).
    
    Results:
    We obtained 54 samples from 54 patients. Age range is 42 to 75 years, mean 60 and median 61 years old. All cases had a histologic diagnosis of SCLC. The genomic analysis found 88 affected genes with 230 alterations. The most common affected genes: Tp53 alteration, 45 cases (83%) and Rb1 33 cases (61%). There were an average of 4.3 mutations per patient; with a median of 4 mutations per patient, with a minimum of 0 and a maximum of 13. Figure 1
    
    
    
    Conclusion:
    Sustained investigations and sequencing of larger numbers of SCLC are aiming to identify potential actionable mutations in these tumors. The ultimate goal is to determine new therapies and optimal treatment strategy based on the genomic profile.